Transfusion‐Free Techniques in Pediatric Live Donor Liver Transplantation

Jabbour, Nicolas; Singh, Gaurav; Thomas, D. Winton; Stapfer, Maria; Mateo, Rod; Sher, Linda; Selby, Rick; Genyk, Yuri

doi:10.1097/01.mpg.0000157590.23126.fd

Cited by 15 publications

(13 citation statements)

References 14 publications

(14 reference statements)

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“…Plasma transfusion is indicated during the anhepatic phase of liver transplant, especially to maintain the levels of liverderived factors with short half-lives (e.g., FVII); however, even then the number of units used varies tremendously across institutions. Remarkably, liver transplant may be performed successfully without any blood component use, as reported by Jabbour and coworkers 3,4 in their study of Jehovah's Witness patients.…”

Section: Replacement Of Multiple Coagulation Factor Deficienciesmentioning

confidence: 84%

Plasma components: properties, differences, and uses

2012

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General use of plasma components includes replacement for multiple coagulation factor deficiencies, for treatment of single coagulation factor deficiencies for which a concentrate is unavailable, and as a replacement fluid used in therapeutic plasma exchange for thrombotic thrombocytopenic purpura. Four major products currently transfused are fresh‐frozen plasma (FFP), plasma frozen within 24 hours of phlebotomy (FP24), cryoprecipitate‐poor plasma (CPP), and thawed plasma. FP24, CPP, and thawed plasma contain decreased amounts of labile coagulation factors. Pathogen reduction technology has included solvent/detergent, methylene blue, and ultraviolet light irradiation with psoralen or riboflavin treatment and is available in Europe but not in the United States. Pathogen‐reduced plasma may contain reduced levels of certain coagulant and/or anticoagulant factors compared to FFP. Clinical findings with pathogen‐reduced plasma have provided an impetus to the US Food and Drug Administration to promulgate specific requirements for approval of novel plasma products, some of which may be too burdensome for the industry to readily overcome.

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Section: Replacement Of Multiple Coagulation Factor Deficienciesmentioning

confidence: 84%

Plasma components: properties, differences, and uses

2012

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“…Within the living donor liver population, donors for pediatric recipients (12) have less morbidity and mortality than donors for adult recipients in which a right hepatectomy, rather than a left lateral segmentectomy, is performed (13). Ethical analysis of living liver donation generally focuses on the risks and benefits to the donor, as donors are exposed to pre‐operative testing, as well as surgery and anesthesia for a procedure for which they have no clinical need.…”

Section: Discussionmentioning

confidence: 99%

To Do or Not to Do Living Donor Hepatectomy in Jehovah's Witnesses: Single Institution Experience of the First 13 Resections

Jabbour

Singh

Bramstedt

et al. 2005

American Journal of Transplantation

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“…und exemplarisch die Untersuchung von Nelson u. Bowen [33] Inzwischen kennen wir Hunderte von Publikationen, teilweise mit stattlichen Zahlen, über die fremdblutfreie operative Maximaltherapie an Zeugen Jehovas: Eingriffe wie Herz-oder Lebertransplantation [10,23,24], große Operation bei anämischen Schwangeren [7] oder große bauchchirurgische Eingriffe wie Whipple-Operation [17,21,29]. Auch Kleinkinder mit weniger als 5 kgKG wurden am Herzen operiert oder lebertransplantiert, ohne Blut zu verwenden [5,12,14,22,25]. Teilweise hatten Patienten über Stunden oder Tage kaum messbare Hämoglo-binkonzentrationen [38] und haben dennoch mit maximaler Therapie, aber ohne Blut überlebt.…”

Section: Fremdblutfreie Operationen An Zeugen Jehovasunclassified

Klinische Aspekte der Therapie mit Erythrozyten

Bormann

2007

Anaesthesist

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With the decreased risk of homologous blood transfusions, the costs of blood products have become increasingly important for hospitals with major surgical procedures and oncologic treatment. It is well established from clinical physiology that a hemoglobin concentration (cHb) lower than 6.21 mmol/l (10 g/dl) is enough to serve the oxygen demand of the tissues, but transfusion of erythrocytes is still liberally carried out. Data obtained from Jehovah's Witnesses, who categorically refuse blood transfusions, demonstrate that they have an outcome similar to patients who are transfused. The lessons we have learned from Jehovah's Witnesses should result in an emotionless discussion, and a reduction in transfusion requirements.

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Transfusion‐Free Techniques in Pediatric Live Donor Liver Transplantation

Cited by 15 publications

References 14 publications

Plasma components: properties, differences, and uses

Plasma components: properties, differences, and uses

To Do or Not to Do Living Donor Hepatectomy in Jehovah's Witnesses: Single Institution Experience of the First 13 Resections

Klinische Aspekte der Therapie mit Erythrozyten

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