Intraoperative autologous transfusion: its role in orthotopic liver transplantation.

In our orthotopic liver transplantation program, intraoperative autologous transfusion was used in 89 of the first 100 procedures. In these 89 cases, intraoperative autologous transfusion provided a mean of 6.2 erythrocyte units per case or 32% of the total intraoperative erythrocyte requirements. The maximal number of erythrocyte units administered to any patient was 36.6 units (and 51% of the erythrocyte requirements). The most rapid rate of reinfusion of intraoperatively salvaged blood (11.8 units/h) occurred during reperfusion. No coagulopathy, infectious sequelae, or other complications were attributable to intraoperative autologous transfusion. In patients with large volumes of blood loss, intraoperative autologous transfusion is cost-effective, apart from the consideration of its medical benefits. Use of intraoperative autologous transfusion in liver transplantation resulted in conservation of erythrocytes and reduction in exposure to homologous blood and blood components.