Anesthesia & Clinical Research
Open Access

Abstract

Bloodless Liver Transplantation: ROTEM guided Rational Prophylactic use of Recombinant Activated Factor VII

Fayed N, Hegazy O and Tanaka K

Background: Improvement of surgical and anesthetic techniques, allowed total avoidance of blood transfusion during liver transplantation (LT) in some cases. The last years showed much debate about prophylactic administration of rFVIIa with no guide for its rational use. Giving that it is off label, preoperative ROTEM assessed coagulation reserve may help its judicious use. Patients and methods: 3 groups retrospectively studied; (NRNB) n=38 not given rFVIIa and no blood transfusion (BT), (RNB) n=43 given rFVIIa and no BT and (RAB) n=35 given rFVIIa and BT. 40 ug/kg rFVIIa were given. Comparison NRNB vs. RNB group answers need or not need rFVIIa to achieve bloodless surgery (decision of admission), while RNB vs. RAB group determine which patients rFVIIa can help to achieve bloodless surgery ( responders and non responders). Data collected: Preoperative Extem, Fibtem, hemoglobin (HB), INR, platelet, fibrinogen, blood loss, and blood transfused in RAB group.