Bloodless Liver Transplant Surgery Reduces Risks
It is a proven fact in the last 15 years that blood transfusions in organ transplantation, cancer surgery and other surgical operations have negative effects on the recovery of patients. Particular attention should be paid to the physiology of patients in organ transplants. The more blood is used, the more patients’ metabolism deteriorates, and the recovery process is delayed after surgery. Morbidity and mortality increase. For this reason, bleeding should be minimized during surgery. Because every blood transfusion means a trauma for the patient.
Only one-day stay in intensive care unit
Using less blood transfusion in liver transplants contributes to patients staying in the intensive care unit for 1 or maximum 2 days and being discharged in a short time. The less blood is used; the less risk the patient has of developing a complication. Especially in the case of liver failure, the already existing hemostasis disorder can become much more complicated in liver transplantation. It may cause bleeding disorders in patients. In the transplantations we perform at our liver transplant center, we use blood for patients with anemia during the initial period of the surgery.
Liver failure patients are prone to bleeding
Liver transplantation is one of the most blood-used surgeries among all surgical procedures. In patients with end-stage liver failure, hemostasis is impaired for many reasons. These include low platelet secretions and causes of coagulation factor (prothrombin) disorder. These patients may experience excessive bleeding even during minor surgical interventions. Surgical procedures can be performed on these patients only with special precautions.
The rate of blood used is very low
In the liver transplants we have performed in the last year, we have not given any blood transfusion to 17 of our patients. Our blood usage rate for the rest of our patients is 2.3 units per patient, including patients with pre-operative anemia. The mean preoperative MELD score (the ratio that determines the degree of disease) of our patients was 19. When we look at the world standards, the average blood use in such a patient group is 5-10 units.
It’s no coincidence that we use less blood
The important thing here is surgical technique and anesthesia monitoring; that is, the operation of the surgical team and the anesthesia team work in harmony during the operation. In order to identify and evaluate undesirable problems during the operation, the physiological parameters of the patient should be monitored and observed. The surgical technique we use is important. We use the anatomical structure very well to remove the liver. We do not go into areas that may bleed. We use techniques to make the surgery as simple as possible. It is no coincidence that we use less blood; We provide this with our special techniques.
Liver transplantation should be standardized
Every stage in liver transplantation should be very well standardized. The surgical technique should not be applied differently unless it is necessary. We provide organ transplantation with simple techniques that do not pose a vital risk to the patient. We try to stick to normal anatomy. We do not use alternative techniques. In this way, our rates of so-called “re-exploration”, which require re-operation after liver transplants, are also very low. To date, we have performed re-exploration in a total of 7 patients.