Recovery from Extreme Hemodilution (Hemoglobin Level of 0.6 g/dL) in Cadaveric Liver Transplantation

• Published in: A & A case reports Vol. 4; no. 10; p. 132
• Main Authors: Kariya, Taro, Ito, Nobuko, Kitamura, Takayuki, Yamada, Yoshitsugu
• Format: Journal Article
• Language: English
• Published: United States 15.05.2015
• Subjects: Blood Grouping and Crossmatching - classification; Blood Loss, Surgical - physiopathology; Blood Transfusion - methods; Cadaver; Hemodilution - adverse effects; Hemodilution - methods; Hemoglobins - metabolism; Hemorrhage - blood; Hemorrhage - etiology; Humans; Japan; Liver Cirrhosis, Biliary - blood; Liver Cirrhosis, Biliary - surgery; Liver Transplantation - adverse effects; Liver Transplantation - methods; Male; Middle Aged; Oxygen - administration & dosage; Plasma; Treatment Outcome; Japan
• ISSN: 2325-7237
• DOI: 10.1213/xaa.0000000000000132

Decompensated hepatic failure occurred in a patient with a rare blood type. The patient had extreme hemodilution due to massive bleeding during liver transplantation. A shortage of matched and universal donor blood prompted us to transfuse albumin and fresh frozen plasma for intravascular volume resuscitation. The lowest hemoglobin was 0.6 g/dL, accompanied by ST depression and a serum lactate of 100 mg/dL. The accuracy of the measured value of 0.6 g/dL was confirmed. However, the patient recovered from this critical situation after transfusion, and he was eventually discharged from the hospital without significant sequelae. Maintaining normovolemia, administering pure oxygen, ensuring appropriate anesthetic depth, and maintaining minimal inotropic support were essential for this patient's survival during massive bleeding.