IMPACT OF APROTININ ON BLOOD-TRANSFUSION REQUIREMENTS IN LIVER-TRANSPLANTATION

A retrospective study was carried out to ascertain the blood bank prov ision required to support a liver transplant programme and to assess t he effect of intraoperative aprotinin on blood product requirements in liver transplant recipients with cirrhosis. Sixty patients with end-s tage liver disease underwent 62 consecutive orthotopic liver transplan ts between October 1988 and January 1991. The total and intraoperative requirements of red cells, platelets and fresh frozen plasma (FFP) we re analysed for three groups of liver transplant recipients, those wit hout cirrhosis (n = 15), those with cirrhosis (n = 25) and those with cirrhosis who received intraoperative aprotinin (n = 20). Fifteen with out cirrhosis had mean total requirements of 15 units of red cells, 18 units of platelets and 16 units of FFP. Twenty patients with cirrhosi s who received intraoperative aprotinin had broadly similar requiremen ts. However, blood product requirements for 25 patients with cirrhosis were significantly greater (46 units of red cells, 41 units of platel ets, 43 units of FFP, excluding the seven patients with primary biliar y cirrhosis). We conclude that a liver transplant programme can be sup ported by a teaching hospital blood bank. The use of intraoperative ap rotinin significantly reduces blood product requirements.