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Intraoperative cell salvage with autologous transfusion in liver transplantation

World Journal of Gastrointestinal Surgery 2019年第1期11卷 11-18页

作者： Marcelo A Pinto Marcio F Chedid leo sekine Andre P Schmidt Rodrigo P Capra Carolina Prediger Jo?o E Prediger Tomaz JM Grezzana-Filho Cleber RP Kruel Division of Gastrointestinal Surgery and Liver Transplantation Hospital de Clínicas de Porto Alegre Medical School of UFRGS Division of Hematology Hospital de Clínicas de Porto Alegre Medical School of UFRGS Division of Anesthesia and Perioperative Medicine Hospital de Clínicas de Porto Alegre Medical School of UFRGS

Liver transplant(LT) is the primary treatment for patients with end-stage liver disease. About 25000 LTs are performed annually in the world. The potential for intraoperative bleeding is quite variable. However, massive bleeding is common and requires blood transfusion. Allogeneic blood transfusion has an immunosuppressive effect and an impact on recipient survival, in addition to the risk of transmission of viral infections and transfusion errors, among *** to prevent excessive bleeding or to use autologous blood have been proposed to minimize the negative effects of allogeneic blood *** reinfusion of autologous blood is possible through previous selfdonation or blood collected during the operation. However, LT does not normally allow autologous transfusion by prior self-donation. Hence, using autologous blood collected intraoperatively is the most feasible option. The use of intraoperative blood salvage autotransfusion(IBSA) minimizes the perioperative use of allogeneic blood, preventing negative transfusion effects without negatively impacting other clinical outcomes. The use of IBSA in patients with cancer is still a matter of debate due to the theoretical risk of reinfusion of tumor cells. However, studies have demonstrated the safety of IBSA in several surgical procedures, including LT for hepatocellular carcinoma. Considering the literature available to date, we can state that IBSA should be routinely used in LT, both in patients with cancer and in patients with benign diseases.

关键词： Liver transplantation Cell saver Hepatocellular carcinoma Blood transfusion Cell salvage

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