Intra-operative acute isovolemic homodilution is safe and effective in eliminating allogeneic blood transfusions during right hepatic lobectomy: Comparison of living donor versus non-donors
Acute isovolemic hemodilution; Allogeneic blood transfusion; Liver resection; Living liver donors
Background. Multiple studies have shown acute isovolemic hemodilution (AIH) to be safe and effective during liver resection to limit the use of banked blood. However, no studies to date have studied AIH in living donor right hepatectomy. Conventional right hepatectomies for living donors is not identical to non-donor right hepatectomies. Since division of the parenchyma is often performed without devascularization of the right lobe, blood loss may be significantly higher. Methods. Ten consecutive patients undergoing living donor right hepatectomies (LDRH) and ten consecutive patients undergoing nondonor right hepatectomies (NDRH) were compared using AIH. Results. There was no mortality or morbidity related to the use of AIH. No allogeneic blood transfusions were required in either group, intra-operatively or post-operatively. There was no significant difference in post-operative hematocrit, average estimated blood loss, and average fluid replacement. Average hospital length of stay and operating room time were longer for the LDRH. Conclusion. AIH can be performed safely and effectively in both LDRH and NDRH without subjecting patients to unnecessary risks of allogeneic blood transfusions. © 2005 Taylor & Francis Group Ltd.
Rhim, C., Johnson, L., Kitisin, K., Lu, A., Fishbein, T., Broseker, L., Yosaitis, J., Manley, J., & Plotkin, J. (2005). Intra-operative acute isovolemic homodilution is safe and effective in eliminating allogeneic blood transfusions during right hepatic lobectomy: Comparison of living donor versus non-donors. HPB, 7 (3). http://dx.doi.org/10.1080/13651820510028963