Blood usage for liver transplantation in infants and children
Danielson CF., Waldo CT., Rothenberger SS., Fitzgerald JF., Pescovitz MD., Friend PJ., McCarthy LJ.
Nineteen patients, aged 2 1/2 years or younger, underwent liver transplantation at the Indiana University Medical Center. Three required a second graft and one required a third. The transfusion requirements of these children were compared with the needs of adults receiving liver allografts at the same institution. When expressed as units of blood components transfused per kilogram of patient weight, the intraoperative use for the two groups was similar. After surgery, pediatric patients required the greatest hemotherapy support and received considerably larger doses of fresh frozen plasma than did adults. Thus, in contrast to adults, who require greater hemotherapy support during surgery, these pediatric patients required the greatest amount of blood components posttransplantation. Ten of the 19 pediatric patients were cytomegalovirus (CMV) -seronegative before transplantation. Three of the 10 seroconverted after transplantation. Two had received organ grafts from CMV-seropositive donors, but the third received a liver graft and cellular blood components from only CMV-seronegative donors. The cause of this patient's seroconversion was unknown.