What is the role of autotransfusion in preventing heterologous transfusions in liver transplantation?

Updated: Apr 19, 2019
  • Author: Vanessa A Olcese, MD, PhD; Chief Editor: Ron Shapiro, MD  more...
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Answer

Answer

Use of the cell-saver device is a safe and effective method of salvaging RBCs during OLT. Autotransfusion decreases some of the complications of homologous transfusions, including citrated products, infection transmission, metabolic derangements, benzodiazepine toxicity, and coagulopathy. Additionally, autotransfusion conserves blood bank resources and reduces overall costs. A systematic review by Davies et al concluded that cell salvage may be a cost-effective method to reduce exposure to allogeneic blood transfusion, but acute normovolemic hemodilution may be more cost-effective than cell salvage. [48, 49]

Autotransfusion for living-donor liver transplantation has also been successful in preventing heterologous transfusion. Its use also has been described in a Jehovah's Witness patient undergoing OLT; a continuous circuit was established and maintained.


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