Liver transplantation is a procedure which is known for its massive intra operative bleeding. Depending on nature of liver disease and experience of transplant team, this problem varies from patient to patient. In our survey we analyzed data of intraoperative bleeding and blood products transfusion in 120 adult orthotopic liver tranplantation. Data such as intraoperative blood loss, infused pack cell, infused fresh frozen plasma, infused platelet, the frequency of rapid infusion system and cell saver usage gathered from anesthesia record of 120 performed orthotopic liver transplantation and were analyzed retrospectively over a period of five years. Correlation test between date and blood loss per kilogram revealed a decrease in blood loss with the passage of time (P<0.05). Overall mean intra operative blood loss was 60cc/kg. Maximum blood loss was 23000 cc (358cc/kg) and minimum blood loss was 400cc (7.4 cc/kg). In 3 patients (2.5%) there was no need for blood transfusion (desired hematocrite=30-33%). In 41 patients (34.2%) there was no need for transfusion of fresh frozen plasma (monitored with thromboelastography). In 70 patients (58.3%) there was no need to tranfuse platelet (monitored with thromboelastography). The rate of rapid infusion system or cell saver usage have been decreased with the improvement of the team experience.
Conclusion: Although massive intra operative blood loss is an expected phenomena in liver transplantation, improvement in the experience of the team has a dramatic role in decreasing blood loss and blood products transfusion respectively.