An Audit of the Variety of the Use of Blood Products During Liver Transplantation in Three UK Liver Transplant Centres

Introduction: Intraoperative blood and products usage during Liver Transplantation (LT) may vary between LT centres. Methods: Retrospective audit of adult patients undergoing LT for chronic liver disease at three UK transplant centres (Termed A, B and C) was undertaken. Patient demographics, transplant characteristics, baseline blood testing, donor characteristics, blood and products usage and one-year survival were compared. Results: With respect to baseline blood test, significantly lower fibrinogen and haemoglobin pre-operative levels were observed in centre C. Patients undergoing LT at Centre A received a significantly smaller volume of Processed Red Blood Cells (PRBCs) (Median 0mL) than Centres B or C (Median 560mL and 750mL, respectively). With respect to Fresh Frozen Plasma (FFP) use, Centre B used significantly more (median 1796mL) than Centre A (median 1000mL) and Centre C (median 0mL). Total blood products used intraoperatively were statistically different between all centres (Median 1500 mL vs 2742ms vs 1000mL respectively). One-year survival was very similar in all three centres (Centre B 95%, Centre C 93.3% and Centre A 92.6%). Discussion: This audit demonstrates the varied nature of blood and products transfusion practices among the study centres but did not demonstrate the impact of the use of blood and products intraoperatively on one-year survival. Keywords: liver transplantation, blood transfusion, anaesthesia