Die Lebertransplantation ist der Wahleingriff mit dem höchsten Risiko einer Massivtransfusion, wobei hier Rekordwerte von über 125 1 berichtet werden. Es wird ein Überblick über das Vorgehen im eigenen Arbeitsbereich gegeben. Nach einer Serie von vier Patienten mit jeweils mehr als 100 Konserven Transfusionsmenge wurde zur präoperativen Optimierung der Gerinnung bei fünf Patienten eine Plasmapherese durchgeführt, wenn der Normotest unter 40% lag. Bei alien Patienten wurde auβerdem die Indikation zur Thrombozytengabe wesentlich groβzügiger gestellt; schon bei Werten unter 120000 wurden Konzentrate transfundiert. Dadurch lieβ sich der Blutver-brauch entscheidend senken.

Keywords:
Lebertransplantation, Gerinnung, Blutverbrauch
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© 1985 S. Karger AG, Basel
1985
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