Effects of vasoactive agents on blood loss in liver transplantation - Tapa blanda

The purpose of this work was to evaluate the effects of vasoactive drugs, on blood loss / transfusion requirements during liver transplantation. A retrospective analysis of 110 liver transplantation cases was performed. The variables studied were: blood loss, amounts of transfused blood products, infused colloids and crystalloids; hemodynamic parameters; dosage of vasoactive drugs, short - and long-term outcome and 1-year mortality. Study group (15 patients) that received a low-dose (0.04U/min) vasopressin infusion alongside with phenylephrine and epinephrine. Control group (95 patients) received the same vasoactive agents except vasopressin infusion. Anesthetic and transfusion managements in both groups were otherwise identical. Blood loss was in 50.2% lower and total blood loss was in 38.8% lower in the vasopressin group in comparison with control group. A low-dose (0.04U/min) vasopressin infusion may be an effective technique for blood loss reduction during liver transplantation. This work addresses problems, commonly encountered by anesthesiologists, who provide anesthesia and post-operative management for liver transplantation procedure.

Alexander A. Vitin, MD, Ph.D, Associate Professor, Head of Transplant Anesthesia Division, Department of Anesthesiology, University of Washington Medical Center, Seattle, WA, US. Area of expertise and main field of research: anesthesia management and hemodynamic optimization during liver transplantation in patients with End-Stage Liver Disease.