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Clinical Transfusion Medicine - part 4

Như vậy, trong giai đoạn trước đó của phương pháp này, số lượng lớn các tế bào hồng cầu được yêu cầu, và liên quan với điều này, truyền huyết tương và / hoặc tiểu cầu. Nếu nồng độ fibrinogen giảm chóng mặt thấp, cryoprecipitate cũng có thể được truyền. Ghép gan, khi lần đầu tiên khởi xướng, có thể được kết hợp với truyền của hơn 100 thành phần máu / trường hợp. | Blood Transfusion in Surgery IV Blood Transfusion in Solid Organ Allografts 55 postoperative setting a hypercoagulable state has also been reported which can result in thrombosis. Thus in the earlier phase of this procedure large numbers of red cells are required and associated with this the transfusion of plasma and or platelets. If fibrinogen levels drop precipitously low cryoprecipitate may also be transfused. Liver transplantation when first initiated can be associated with the transfusion of more than 100 blood components case. As experience is gained however the blood transfusion requirements frequently drop by more than two thirds. The indication for transplantation may also influence the transfusion requirements those undergoing transplantation for primary biliary cirrhosis or carcinoma use fewer blood products than those with other diagnoses such as sclerosing cholangitis. Patients with red cell alloantibodies often receive incompatible units of red cells early in the procedure since they are subsequently shed during intraoperative bleeding and the more compatible red cells are transfused later in the procedure. This is in contrast to standard blood banking practice where the most compatible blood would ordinarily be transfused first. CMV seronegative patients should receive CMV low risk products. Leukoreduction by filtration would appear optimal for these patients. As shown in Table 12.2 current blood use in liver transplantation can be considerable. HEART TRANSPLANTATION Heart transplantation presents many similar transfusion considerations as occur in cardiac revascularization surgery Chapter 10 . An important consideration is the need to avoid primary CMV transmission by blood transfusion in these patients perioperatively and the use of leukoreduced blood is therefore appropriate. Current blood use in heart transplantation is shown in Table 12.2. 12 LUNG TRANSPLANTS The blood transfusion requirements in lung transplantation are dependent on whether a .