Predicting intraoperative blood loss based on the scale of liver failure assessment

Introduction: Liver transplantation is one of the most difficult, complicated and time-consuming surgeries performed within the abdominal cavity. Implantation of the donor’s liver requires a number of venous and arterial anastomoses. Operation is at high risk of intraoperative bleeding, caused by many factors including: etiology and severity of liver disease rated according to scale of Child-Turcotte-Pugh (C-T-P), Model For End Stage Liver Disease (MELD), coagulation disorders, surgical difficulties. Blood loss and individual blood supply for transfusions are difficult to predict at the patient’s preparation stage for surgery.

Aim of the study: The purpose of the work was to establish a simplified regimen for predicting blood loss during liver transplantation and to plan its optimal reserves according to the severity of liver cirrhosis.

Material and methods: The study enrolled 88 patients, including 59 men and 29 women, aged 19 to 67, who underwent liver transplantation. The most frequent reason for transplantation was liver cirrhosis resulting from viral hepatitis C (45.45%). Retrospective analysis of data obtained from qualification protocol for liver transplantation was applied.

Results: The amount of lost blood in liver transplant patients showed statistically significant differences (p ≈ 0.026), depending on C-T-P scale groups. At every point of the C-T-P scale increases by 334 ml blood loss (R2 = 0.683; p < 0.001).

Conclusions: The Child-Turcotte-Pugh scale is suitable for predicting the need for blood preparations during liver transplantation. The built model allows predicting the loss of blood and planning its optimal reserves.