Transfusion Requirements After Orthotopic Liver Transplantation

A Randomized, Controlled Pilot Trial of Transfusion Requirements After Orthotopic Liver

The objective of this trial is to evaluate different transfusion strategies in patients after liver transplantation. Patients in the experimental arm will be given red blood cell (RBC) transfusion according to a liberal strategy, i. e., transfusions should be given, when hemoglobin concentration falls below 10 g/dl, and hemoglobin concentration should be maintained between 10 and 12 g/dl. Patients in the control arm will be given red blood cell (RBC) transfusion according to a restrictive strategy, i. e., transfusions should be given, when hemoglobin concentration falls below 8 g/dl, and hemoglobin concentration should be maintained between 8 and 10 g/dl.

Inclusion Criteria:

• Patients undergoing liver transplantation
• Patients considered to have euvolemia after initial treatment by attending physicians

Exclusion Criteria:

• Patients age 18 or less
• Patients undergoing combined liver-kidney transplantation
• Patients requiring renal replacement therapy before liver transplantation for longer than two weeks
• Inability to receive blood products
• Patient with active blood loss at the time of enrollment
• Pregnancy
• Imminent death