| Unexpected Massive Bleeding during Liver Transplantation in Patients with Budd-Chiari Syndrome: A case report. |
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Ha Na Song, Sung Moon Jeong, Young Joo Seo, Hee Yeong Kim, Hye Young Jeon, Jae Moon Choi, Jun Gol Song, Kyung Don Hahm, Gyu Sam Hwang |
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Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. anesjsm@amc.seoul.kr |
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| Abstract |
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Budd-Chiari syndrome (BCS) is a heterogenous group of disorders characterized by obstruction of hepatic venous outflow. Severe liver cirrhosis and limited cardiac reserve in patients with BCS makes them less tolerant to liver transplantation. We experienced two cases of massive bleeding during living donor liver transplantation in patients with BCS. Blood products and fluids were rapidly infused with a rapid infusion system, final infusion volume in these two patients were 177 L and 193 L, and the use of Cell Savers allowed for the patient's blood products to be saved. The patients were managed successfully and recovered uneventfully with advanced monitoring, including monitoring of their jugular venous oxygen saturation and continuous cardiac output. Therefore, rapid infusion systems and Cell Savers, along with advanced monitoring, are necessary in the event of massive bleeding during liver transplantation. |
| Key Words:
Budd-Chiari syndrome; liver transplantation; massive bleeding |
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