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World J Gastroenterol. May 28, 2014; 20(20): 6146-6158
Published online May 28, 2014. doi: 10.3748/wjg.v20.i20.6146
Published online May 28, 2014. doi: 10.3748/wjg.v20.i20.6146
Transfusion and coagulation management in liver transplantation
Ben Clevenger, Susan V Mallett, Department of Anaesthesia, Royal Free NHS Foundation Trust, London NW3 2QG, United Kingdom
Author contributions: Clevenger B and Mallett SV contributed equally to this work.
Correspondence to: Susan V Mallett, MBBS, FRCA, Consultant Anaesthetist, Department of Anaesthesia, Royal Free NHS Foundation Trust, Pond Street, London NW3 2QG, United Kingdom. susan.mallett@nhs.net
Telephone: +44-20-77940500 Fax: +44-20-78302245
Received: October 9, 2013
Revised: February 10, 2014
Accepted: March 12, 2014
Published online: May 28, 2014
Revised: February 10, 2014
Accepted: March 12, 2014
Published online: May 28, 2014
Core Tip
Core tip: Liver transplantation was historically associated with major blood loss. Over the years, improvements in both surgical and anaesthetic management have made transfusion free transplantation an increasingly attainable reality. Research into the complex nature of the coagulopathy of liver disease, has led to the concept that the haemostatic profile is “re-balanced” in these patients, and that stable patients do not have an inherent bleeding diathesis, but rather a reduced reserve, and can be readily tipped towards a bleeding or thrombotic tendency. This review article discusses the various approaches that can be taken to adopt the principles of patient blood management in these patients.