Comparison of the group treated with terlipressin and group no treated with terlipressin in terms of blood loss in blood transfusion reduction in liver transplant recipient

Abstract

Background: Liver transplantation is historically associated with major blood loss and a massive need for transfusions of blood products. The first liver transplant was attempted by Thomas Starzl in 1963, and the patient along with the next four, died from bleeding. The operative technique had been defined in animal experiments, but the surgical team was not prepared for the technical complications associated with liver transplants.The first successful human liver transplantation was performed in 1967 and transfusions were more than 100 units of red blood cells (RBC) during the first years of liver transplant activity. Since then a steady decrease in intraoperative blood loss and the need for blood product transfusions during liver transplantation has been observed, reflecting an overall improvement.

Objective: To point out the effects of vasoactive drugs, especially low-dose Terlipressin infusions on blood loss and blood transfusion requirements during living-donor liver transplantations.

Methods:A retrospective analysis of 200 living-donor liver transplantation (LDLT) cases was analyzed.During liver transplantation, the variables studied were blood loss, blood transfusion, and blood volumes returned by the cell-saver. The study subjects were mainly divided into two groups i.e. Case & Control. Both groups were consisting of 100 patients each. The Case group received Terlipressin while the Control group didn’t receive Terlipressin. Both groups were equally treated in anesthetic and transfusion management.

Results:The calculated blood loss during liver transplantation waslower in the Case group as compared to the Control group i.e. mean value of the Case group was 1.5 while the mean value of the Control group was 3.37. Furthermore, the reduction of blood transfusion was also lower in the Case group as compared to the Control group i.e. mean value of the Case group was 1.7 while the mean value of the Control group was 4.85. The results were highly statistically significant because (p=<0.01).

Conclusions: To minimize blood loss and blood transfusion in liver transplantation may be contributed to the use of Terlipressin infusion. A low-dose (0.04U/min) terlipressininfusion may be an appropriate solution forthe reduction of blood loss and transfusion during liver transplantation.