• A & A case reports · May 2015

    Case Reports

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

    • Taro Kariya, Nobuko Ito, Takayuki Kitamura, and Yoshitsugu Yamada.
    • From the Departments of *Cardiovascular Medicine and †Anesthesia and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan; and ‡Department of Anesthesiology, Toho University Sakura Medical Center, Sakura, Chiba, Japan.
    • A A Case Rep. 2015 May 15;4(10):132-6.

    AbstractDecompensated 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.

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