الفهرس | Only 14 pages are availabe for public view |
Abstract Blood conservation or transfusion-free procedures are more of a complete science, in which the preparation starts preoperatively and continues through the operation and the postoperative phase. Rapid development of novel drugs is also beginning to play a role in containing coagulopathy and increasing hemopoiesis. Drugs such as human recombinant erythropoietin to increase the pretransplantation RBC mass, aprotinin, tranexamic acid, or ε-aminocaproic acid to inhibit fibrinolysis have now become mainstream strategies. The utility of the novel drug recombinant factor VIIa in OLTs is proved useful and safe in the management of coagulopathy related oozing. Intraoperative cell salvage is an effective method for collecting blood from the operative field, where the RBCs are subsequently washed and reinfused. The drawback of ICS is that it salvages only the RBCs and no clotting factors. On the other hand, ANH preserves the integrity of the RBCs and clotting factors, ensuring the availability of safe, fresh, autologous blood. Blood transfusion is also a function of a human component, both on the surgical and anesthesiological front. Surgical skill, the appropriate use of cautery, and specific strategies directed at maintaining low central venous pressure are important factors. |