Abstract:
Preoperative anemia is a common condition in surgical patients, particularly those with end-stage liver failure. Liver transplant (LT)
represents the last therapeutic option for end-stage liver failure patients. The procedure is often associated with major blood loss,
requiring allogeneic blood product transfusions. The prevalence of anemia in LT recipients ranges from 2% to 28% and the
prevalence of iron deficiency (ID) among LT recipients ranges from 45% to 60%. Several factors may contribute to anemia,
including occult gastrointestinal bleeding, folate and vitamin B12 deficiency, autoimmune hemolysis, altered oxide-reductive
balance, hypersplenism (in adults), and nutritional deficiency (in children). The intensive care unit (ICU) plays a vital role in the
practice of LT recipients. A prolonged ICU stay consumes physical and financial resources. Among LT patients, it may be
associated with an increased risk of complications and greater mortality. Preoperative ID may be able to identify patients who are
likely to need a prolonged ICU stay after LT because of preoperative ID is associated with high intraoperative PRBC transfusion
requirements in LT patients. Furthermore, the quantity of blood products administered intraoperatively is a well known
independent risk factor for a prolonged ICU stay after LT. Improvements in preoperative evaluation, surgical techniques, and
intraoperative anesthesia of LT recipients during the past decade have resulted in shorter ICU stay. We believe that to avoid
prolonged ICU stay, transfusion is important during LT.
