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dc.contributorMejia, Gilberto
dc.contributorRivera, Jairo
dc.contributor.advisorFranco Gruntorad, Germán Andrés 
dc.contributor.advisorAlzate, Juan Pablo 
dc.creatorBallen Tole, Manuel Camilo 
dc.date.accessioned2018-08-17T20:28:31Z
dc.date.available2018-08-17T20:28:31Z
dc.date.created2018-07-26
dc.date.issued2018
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/18312
dc.descriptionIntroducción: El trasplante hepático es un procedimiento salvador en pacientes con patología hepática terminal. La hemorragia que requiere transfusión de glóbulos rojos empaquetados (GRE) es una de las complicaciones más frecuentes y se asocia con un aumento de la morbimortalidad. Objetivo: Identificar factores de riesgo asociados a la transfusión de GRE durante el intraoperatorio en los pacientes adultos sometidos a trasplante hepático en la Fundación CardioInfantil. Métodos: Estudio analítico de casos y controles, se dividió la población de pacientes que fueron llevados al procedimiento en aquellos que requirieron transfusión de GRE y aquellos que no, se analizaron factores de riesgo identificados y conductas que podrían disminuir la probabilidad de transfusión de GRE. La población de referencia fueron los pacientes en quienes se realizó trasplante hepático ortotópico durante 2013-2017. Resultados: Se identificaron 190 procedimientos, la frecuencia de transfusión de GRE fue de 54,2%, posterior al análisis multivariado contrario a lo que había sido concluido por otros investigadores el uso de salvador de células se comportó como factor de riesgo; coincidiendo con lo reportado por otros grupos de trasplante hepático el tiempo de fase anhepática superior a 50 minutos, edad del donante mayor a 39,5 años y como factor protector hemoglobina (Hb) mayor a 12,6 g/dl siendo este último parámetro el que puede ser optimizado previo al procedimiento. Discusión: Se considera que para optimizar la morbimortalidad de los pacientes que van a ser llevados a este procedimiento se debe optimizar la Hb mientras el paciente se encuentre en lista de espera.
dc.description.abstractIntroduction: Liver transplant is a salvage procedure in patients with terminal liver pathology. Hemorrhage with requirement of red blood cell (RBC) transfusion is a common complication associated with increased morbidity and mortality. Objective: To Recognize risk factors associated with intraoperative use of RBC transfusion in adult patients undergoing liver transplantation at CardioInfantil Foundation Center. Method: Sample population consists of patients who required orthotopic liver transplant between 2013-2017. A case control study was performed. the group of patients undergoing the procedure was divided between patients who required RBC transfusion and those who did not require RBC transfusion, risk factors and strategies that could decrease RBC transfusion were analyzed. Results: 190 procedures were included, RBC transfusion requirement frequency was 54,2%; after multivariate analysis and contrary to previous publications, use of cell saver was a risk factor RBC transfusion. Like results reported by other liver transplant groups anhepatic phase more than 50 minutes, donor age more than 39,5 years old and hemoglobin (hb) greater than 12,6 g/dl were protector variables for RBC transfusion. Discussion: To optimize morbidity and mortality of patients undergoing liver transplantation, hb must be optimized.
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dc.language.isospa
dc.sourceinstname:Universidad del Rosario
dc.sourcereponame:Repositorio Institucional EdocUR
dc.subjectTrasplante hepático
dc.subjectTransfusión
dc.subjectGlóbulos rojos
dc.subjectGlóbulos rojos empaquetados
dc.subjectFactores de riesgo
dc.subjectSalvador de células hemoglobina
dc.subject.ddcVarias ramas de la medicina, Cirugía  
dc.subject.lembTrasplantes de hígado
dc.subject.lembEritrocitos
dc.titleFactores de riesgo para transfusión intraoperatoria de globulos rojos en trasplante hepático en la Fundación Cardioinfatil
dc.typemasterThesis
dc.publisherUniversidad del Rosario
dc.creator.degreeEspecialista en Anestesiología FCI
dc.publisher.programEspecialización en Anestesiología FCI
dc.publisher.departmentFacultad de Medicina
dc.subject.keywordTranfusion
dc.subject.keywordLiver transplant
dc.subject.keywordRed blood cells
dc.subject.keywordRisk factors
dc.subject.keywordCell saver
dc.subject.keywordHemoglobin
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.type.spaTrabajo de grado
dc.rights.accesoAbierto (Texto Completo)
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.source.bibliographicCitationParra CO, Cirujana M, María L, Arrázola O, Posso H, Asesor V. Survival in Patients with Liver Transplantation performed in the Fundación Cardioinfantil between 2005 and 2013 Camila. 2015;1–53. Available from: http://repository.urosario.edu.co/bitstream/handle/10336/10554/1015398846-2015.pdf?sequence=1&isAllowed=y
dc.source.bibliographicCitationMejía GA, Olarte-Parra C, Pedraza A, Rivera JB, Benavides CA. Biliary Complications after Liver Transplantation: Incidence, Risk Factors and Impact on Patient and Graft Survival. Transplant Proc [Internet]. 2016;48(2):665–8. Available from: http://dx.doi.org/10.1016/j.transproceed.2016.02.033
dc.source.bibliographicCitationSteadman RH, Wray CL. Anestesia para el trasplante De Órganos Abdominales [Internet]. Miller. Anestesia. Elsevier Espa8#241;a, S.L.U.; 2016. 2262-2291 p. Available from: http://dx.doi.org/10.1016/B978-84-9022-927-9/00074-3
dc.source.bibliographicCitationFeltracco P, Brezzi ML, Barbieri S, Galligioni H, Milevoj M, Carollo C, et al. Blood loss, predictors of bleeding, transfusion practice and strategies of blood cell salvaging during liver transplantation. World J Hepatol. 2013;5(1):1–15.
dc.source.bibliographicCitationCleland S, Corredor C, Ye JJ, Srinivas C, McCluskey SA. Massive haemorrhage in liver transplantation: Consequences, prediction and management. World J Transplant [Internet]. 2016;6(2):291. Available from: http://www.wjgnet.com/2220-3230/full/v6/i2/291.htm
dc.source.bibliographicCitationChidananda Swamy MN. Blood transfusion practices in liver transplantation. Indian J Anaesth. 2014;58(5):647–51.
dc.source.bibliographicCitationStarczewska AMH, Giercuszkiewicz D. Perioperative bleeding in patients undergoing liver transplantation. 2015;48(1):34–40.
dc.source.bibliographicCitationClevenger B, Mallett S V. Transfusion and coagulation management in liver transplantation. World J Gastroenterol. 2014;20(20):6146–58.
dc.source.bibliographicCitationGoldaracena N, Méndez P, Quiñonez E, Devetach G, Koo L, Jeanes C, et al. Liver Transplantation without Perioperative Transfusions Single-Center Experience Showing Better Early Outcome and Shorter Hospital Stay. 2013;2013.
dc.source.bibliographicCitationFayed N, Mourad W, Yassen K, G??rlinger K. Preoperative thromboelastometry as a predictor of transfusion requirements during adult living donor liver transplantation. Transfus Med Hemotherapy. 2015;42(2):99–108.
dc.source.bibliographicCitationGrossman BJ, Modanlou KA, Oliver DA. Liver donor’s age and recipient’s serum creatinine predict blood component use during liver transplantation. Transfusion. 2009;49(12):2645–51.
dc.source.bibliographicCitationLeon-justel A, Noval-padillo JA, Alvarez-rios AI, Mellado P, Gomez-bravo MA, Álamo JM, et al. Point-of-care haemostasis monitoring during liver transplantation reduces transfusion requirements and improves patient 50 outcome. Clin Chim Acta [Internet]. 2015;446:277–83. Available from: http://dx.doi.org/10.1016/j.cca.2015.04.022
dc.source.bibliographicCitationGhaffaripour S, Mahmoudi H, Khosravi MB, Sahmeddini MA, Eghbal H, Sattari H, et al. Preoperative factors as predictors of blood product transfusion requirements in orthotopic liver transplantation. Prog Transplant [Internet]. 2011;21(3):254–9. Available from: http://www.scopus.com/inward/record.url?eid=2-s2.0-84856407653&partnerID=tZOtx3y1
dc.source.bibliographicCitationSolves P, Carpio N, Moscardo F, Lancharro A, Cano I, Moya A, et al. Transfusion management and immunohematologic complications in liver transplantation: Experience of a single institution. Transfus Med Hemotherapy. 2015;42(1):8–14.
dc.source.bibliographicCitationBoin IFSF, Leonardi MI, Luzo ACM, Cardoso AR, Caruy CA, Leonardi LS. Intraoperative Massive Transfusion Decreases Survival After Liver Transplantation. Transplant Proc. 2008;40(3):789–91.
dc.source.bibliographicCitationHendriks HGD, Meer J Van Der, Wolf JTM De, Peeters PMJG, Porte RJ, Jong K De, et al. Intraoperative blood transfusion requirement is the main determinant of early surgical re-intervention after orthotopic liver transplantation. 2005;673–9.
dc.source.bibliographicCitationReichert B, Kaltenborn A, Becker T, Schiffer M, Klempnauer J, Schrem H. Massive blood transfusion after the first cut in liver transplantation predicts renal outcome and survival. Langenbeck’s Arch Surg. 2014;399(4):429–40.
dc.source.bibliographicCitationPereboom ITA, De Boer MT, Haagsma EB, Hendriks HGD, Lisman T, Porte RJ. Platelet transfusion during liver transplantation is associated with increased postoperative mortality due to acute lung injury. Anesth Analg. 2009;108(4):1083–91.
dc.source.bibliographicCitationOzkardesler S, Avkan-Oguz V, Akan M, Unek T, Ozbilgin M, Meseri R, et al. Effects of blood products on nosocomial infections in liver transplant recipients. Exp Clin Transplant Off J Middle East Soc Organ Transplant [Internet]. 2013;11(6):530–6. Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23901878
dc.source.bibliographicCitationKrzanicki D, Sugavanam A, Mallett S. Intraoperative Hypercoagulability During Liver Transplantation as Demonstrated by Thromboelastography. 2013;44(0):852–61
dc.source.bibliographicCitationKs G, Pissanou T, Pikhart H, Vaughan J, Ak B, Br D. Methods to decrease blood loss and transfusion requirements for liver transplantation ( Review ). 2012;(12).
dc.source.bibliographicCitationMunar Gonzalez FD, Montes Romero FR, Rincón JD. DETERMINACION DE PREDICTORES ASOCIADOS A SANGRADO INTRAOPERATORIO Y COMPORTAMIENTO.
dc.source.bibliographicCitationRepine TB, Perkins JG, Kauvar DS, Blackborne L. The use of fresh whole blood in massive transfusion. J Trauma - Inj Infect Crit Care. 2006;60(6 SUPPL.).
dc.source.bibliographicCitationSmith CE. Trauma Anesthesia. 2008. 122 p.
dc.source.bibliographicCitationStahl JE, Kreke JE, Abdul Malek FA, Schaefer AJ, Vacanti J. Consequences of cold-ischemia time on primary nonfunction and patient and graft survival in liver transplantation: A meta-analysis. PLoS One. 2008;3(6).
dc.source.bibliographicCitationHalazun KJ, Al-Mukhtar A, Aldouri A, Willis S, Ahmad N. Warm Ischemia in Transplantation: Search for a Consensus Definition. Transplant Proc. 2007;39(5):1329–31.
dc.source.bibliographicCitationKs G, Pamecha V, Br D. Piggy-back graft for liver transplantation ( Review ). 2011;(1).
dc.source.bibliographicCitationFeltracco P, Brezzi ML, Barbieri S, Galligioni H, Milevoj M, Carollo C, et al. Blood loss , predictors of bleeding , transfusion practice and strategies of blood cell salvaging during liver transplantation. 2013;5(1):1–15.
dc.source.bibliographicCitationEsmat Gamil M, Pirenne J, Van Malenstein H, Verhaegen M, Desschans B, Monbaliu D, et al. Risk factors for bleeding and clinical implications in patients undergoing liver transplantation. Transplant Proc [Internet]. 2012;44(9):2857–60. Available from: http://dx.doi.org/10.1016/j.transproceed.2012.09.085
dc.source.bibliographicCitationFernandes DS, Real CCP, Sá PA, Romão C, Correia FBM, Barros D, et al. Pre-operative predictors of red blood cell transfusion in liver transplantation Diogo. 2014;1–4.
dc.source.bibliographicCitationRana A, Petrowsky H, Hong JC, Agopian VG, Kaldas FM, Farmer D, et al. Blood Transfusion Requirement During Liver Transplantation Is an Important Risk Factor for Mortality. 2013;902–7.
dc.source.bibliographicCitationPirat A, Sargin D, Torgay A, Arslan G. Identification of preoperative predictors of intraoperative blood transfusion requirement in orthotopic liver transplantation. Transplant Proc. 2002;34(6):2153–5.
dc.source.bibliographicCitationMassicotte L, Thibeault L, Roy A. Classical Notions of Coagulation Revisited in Relation with Blood Losses , Transfusion Rate for 700 Consecutive Liver Transplantations. 2015;1(212):538–46.
dc.source.bibliographicCitationGoldaracena N, Méndez P, Quiñonez E, Devetach G, Koo L, Jeanes C, et al. Liver Transplantation without Perioperative Transfusions Single-Center Experience Showing Better Early Outcome and Shorter Hospital Stay. J Transplant [Internet]. 2013;2013:1–7. Available from: http://www.hindawi.com/journals/jtrans/2013/649209/
dc.source.bibliographicCitationWannhoff A, Schemmer P. Relationship Between Conventional Coagulation Tests and Bleeding for 600 Consecutive Liver Transplantations. 2014;13–5.
dc.source.bibliographicCitationMassicotte L, Sassine M-P, Lenis S, Roy A. Transfusion Predictors in Liver Transplant. Anesth Analg [Internet]. 2004;1245–51. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00000539-200405000-00011
dc.source.bibliographicCitationAra??jo T, Cordeiro A, Proen??a P, Perdigoto R, Martins A, Barroso E. Predictive Variables Affecting Transfusion Requirements in Orthotopic Liver Transplantation. Transplant Proc [Internet]. 2010;42(5):1758–9. Available from: http://dx.doi.org/10.1016/j.transproceed.2009.10.007
dc.source.bibliographicCitationDeakin M, Gunson BK, Dunn JA, McMaster P, Tisone G, Warwick J, et al. Factors influencing blood transfusion during adult liver transplantation. Ann R 52 Coll Surg Engl [Internet]. 1993 Sep;75(5):339–44. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2497978/
dc.source.bibliographicCitationModanlou KA, Oliver DA, Grossman BJ. Liver donor’s age and recipient’s serum creatinine predict blood component use during liver transplantation. Transfus Pract. 2009;49(December):2645–51.
dc.source.bibliographicCitationRana A, Petrowsky H, Hong JC, Agopian VG, Kaldas FM, Farmer D, et al. Blood transfusion requirement during liver transplantation is an important risk factor for mortality. J Am Coll Surg. 2013;216(5):902–7.
dc.source.bibliographicCitationMOTSCHMAN TL, TASWELL HF, BRECHER ME, RAKELA J, GRAMBSCH PM, LARSON-KELLER JJ, et al. Intraoperative Blood Loss and Patient and Graft Survival in Orthotopic Liver Transplantation: Their Relationship to Clinical and Laboratory Data. Mayo Clin Proc [Internet]. 1989 Mar 1 [cited 2017 Oct 15];64(3):346–55. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0025619612652562
dc.source.bibliographicCitationCleland S, Corredor C, Ye JJ, Srinivas C, McCluskey SA. Massive haemorrhage in liver transplantation: Consequences, prediction and management. World J Transplant [Internet]. 2016;6(2):291. Available from: http://www.wjgnet.com/2220-3230/full/v6/i2/291.htm
dc.source.bibliographicCitationFindlay JY, Rettke SR. Poor prediction of blood transfusion requirements in adult liver transplantations from preoperative variables. J Clin Anesth. 2000;12(4):319–23.
dc.source.bibliographicCitationSteib a, Freys G, Lehmann C, Meyer C, Mahoudeau G. Intraoperative blood losses and transfusion requirements during adult liver transplantation remain difficult to predict. Can J Anaesth. 2001;48(11):1075–9.
dc.source.bibliographicCitationMassicotte L, Sassine M, Lenis S. Transfusion Predictors in Liver Transplant. 2004;
dc.source.bibliographicCitationPerkins JD. Derivation of a Risk Index for the Prediction of Massive Blood Transfusion in Liver Transplantation. Liver Transplant. 2007;13(3):465–6.
dc.source.bibliographicCitationMangus RS, Kinsella SB, Nobari MM, Fridell JA, Vianna RM, Ward ES, et al. Predictors of Blood Product Use in Orthotopic Liver Transplantation Using the Piggyback Hepatectomy Technique. 2007;3213:3207–13.
dc.source.bibliographicCitationMassicotte L, Beaulieu D, Roy J-D, Marleau D, Vandenbroucke F, Dagenais M, et al. MELD score and blood product requirements during liver transplantation: no link. Transplantation. 2009;87(11):1689–94.
dc.source.bibliographicCitationRoullet S, Biais M, Millas E, Revel P, Quinart a, Sztark F. Risk factors for bleeding and transfusion during orthotopic liver transplantation. Ann Fr Anesth Reanim [Internet]. 2011;30(4):349–52. Available from: http://dx.doi.org/10.1016/j.annfar.2011.01.008
dc.source.bibliographicCitationVarotti G, Santori G, Andorno E, Morelli N, Ertreo M, Strada P, et al. Impact of model for end-stage liver disease score on transfusion rates in liver transplantation. Transplant Proc [Internet]. 2013;45(7):2684–8. Available 53 from: http://dx.doi.org/10.1016/j.transproceed.2013.07.006
dc.source.bibliographicCitationAbstracts of the ILTS (International Liver Transplantation Society) 19th Annual International Congress. Liver Transpl. 2013;Suppl 1:S86-334.
dc.source.bibliographicCitationDe Santis GC, Brunetta DM, Nardo M, Oliveira LC, Souza FF, Cagnolati D, et al. Preoperative variables associated with transfusion requirements in orthotopic liver transplantation. Transfus Apher Sci [Internet]. 2014;50(1):99–105. Available from: http://dx.doi.org/10.1016/j.transci.2013.10.006
dc.source.bibliographicCitationCywinski JB, Alster JM, Miller C, David P, Parker BM. Prediction of Intraoperative Transfusion Requirements During Orthotopic Liver Transplantation and the Influence on Postoperative Patient Survival. 2014;118(2):428–37.
dc.source.bibliographicCitationSchrem H, Focken M, Kaltenborn A. Post-Operative Hemorrhage After Liver Transplantation : Risk Factors and Long-Term Outcome. 2016;46–55.
dc.source.bibliographicCitationNishida S, Nakamura N, Vaidya A, Levi DM, Kato T, Nery JR, et al. Piggyback technique in adult orthotopic liver transplantation: An analysis of 1067 liver transplants at a single center. Hpb. 2006;8(3):182–8
dc.source.bibliographicCitationMassicotte L, Denault AY, Beaulieu D, Thibeault L, Hevesi Z, Nozza A, et al. Transfusion Rate for 500 Consecutive Liver Transplantations. Transplant J. 2012;93(12):1276–81.
dc.source.bibliographicCitationChidananda Swamy MN, Esmat Gamil M, Pirenne J, Van Malenstein H, Verhaegen M, Desschans B, et al. Blood transfusion practices in liver transplantation. Indian J Anaesth [Internet]. 2013;58(5):647–51. Available from: http://www.wjgnet.com/2220-3230/full/v6/i2/291.htm
dc.source.bibliographicCitationByram SW, Gupta RA, Ander M, Edelstein S, Andreatta B. Effects of Continuous Octreotide Infusion on Intraoperative Transfusion Requirements During Orthotopic Liver Transplantation. Transplant Proc [Internet]. 2015;47(9):2712–4. Available from: http://dx.doi.org/10.1016/j.transproceed.2015.07.036
dc.source.bibliographicCitationReal C, Fernandes DS, Couto PS, Barros FC De, Esteves S, Aragão I, et al. Survival Predictors in Liver Transplantation: Time-Varying Effect of Red Blood Cell Transfusion. Transplant Proc [Internet]. 2016;48(10):3303–6. Available from: http://dx.doi.org/10.1016/j.transproceed.2016.08.045
dc.source.bibliographicCitationLiu S, Fan J, Wang X, Gong Z, Wang S, Huang L, et al. Intraoperative Cryoprecipitate Transfusion and Its Association with the Incidence of Biliary Complications after Liver Transplantation-A Retrospective Cohort Study. 2013;8(5):1–8.
dc.source.bibliographicCitationPeduzzi P, Concato J, Kemper E, Holford TR, Feinstem AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49(12):1373–9.
dc.source.bibliographicCitationDenault Y, Beaulieu D, Thibeault L, Hevesi Z, Massicotte L. Transfusion Rate for 500 Consecutive Liver Transplantations : Experience of One Liver Transplantation Center. 2012;93(12):1276–81.
dc.source.bibliographicCitationDe Boer MT, Christensen MC, Asmussen M, Van Der Hilst CS, Hendriks HGD, Slooff MJH, et al. The impact of intraoperative transfusion of platelets and red blood cells on survival after liver transplantation. Anesth Analg. 54 2008;106(1):32–44.
dc.source.bibliographicCitationReichert B, Kaltenborn A, Becker T. Massive blood transfusion after the first cut in liver transplantation predicts renal outcome and survival. 2014;429–40.
dc.source.bibliographicCitationTischer S, Miller JT. Pharmacologic Strategies to Prevent Blood Loss and Transfusion in Orthotopic Liver Transplantation. Crit Care Nurs Q [Internet]. 2016;39(3):267–80. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00002727-201607000-00008
dc.source.bibliographicCitationDetry O, Deroover A, Delwaide J, Delbouille MH, Kaba A, Joris J, et al. Avoiding blood products during liver transplantation. Transplant Proc. 2005;37(6):2869–70.
dc.source.bibliographicCitationSnook NJ, O’Beirne HA, Enright S, Young Y, Bellamy MC. Use of recombinant human erythropoietin to facilitate liver transplantation in a Jehovah’s Witness. Br J Anaesth. 1996;76(5):740–3.
dc.source.bibliographicCitationKong HY, Huang SQ, Zhu SM, Wen XH. Role of anhepatic time in endothelial-related coagulation in liver transplantation. Minerva Anestesiol [Internet]. 2013 Apr [cited 2018 May 23];79(4):391–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23419336
dc.source.bibliographicCitationIsermann B, Sood R, Pawlinski R, Zogg M, Kalloway S, Degen JL, et al. The thrombomodulin-protein C system is essential for the maintenance of pregnancy. Nat Med. 2003;9(3):331–7.
dc.source.bibliographicCitationEdition T, Reves JG, Barnett SR, Mcswain JR, Rooke GA. Geriatric Anesthesiology.
dc.source.bibliographicCitationSankarankutty AK, Mente ED, Teixeira AC, Souza FF, Castro e Silva O de, Andrade CM de, et al. Impact of blood salvage during liver transplantation on reduction in transfusion requirements TT - Impacto do uso do cell saver na redução de transfusão sanguínea durante o transplante de fígado. Acta Cir Bras [Internet]. 2015;21(supl.1):315–7. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-86502006000700011
dc.source.bibliographicCitationKırnap M, Tezcaner T, Ayvazoğlu Soy HE, Akdur A, Yıldırım S, Torgay A, et al. Efficacy of cell saver use in living-donor liver transplant. Exp Clin Transplant. 2015;13:315–7.
dc.source.bibliographicCitationBadenoch A, Sharma A, Gower S, Selzner M, Srinivas C, Wąsowicz M, et al. The Effectiveness and Safety of Tranexamic Acid in Orthotopic Liver Transplantation Clinical Practice: A Propensity Score Matched Cohort Study. Vol. 101, Transplantation. 2017. 1658-1665 p.
dc.source.bibliographicCitationGurusamy KS, Pissanou T, Pikhart H, Vaughan J, Burroughs AK, Davidson BR. Methods to decrease blood loss and transfusion requirements for liver transplantation. Cochrane database Syst Rev [Internet]. 2011;(12):CD009052. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22161443
dc.source.bibliographicCitationVallet B, Robin E, Lebuff G. Venous oxygen saturation as a physiologic transfusion trigger. 2010
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