Abstract
As of March 2009, 67 lung transplants, including 52 from living donors and 15 from cadaveric donors, have been carried out since the first lung transplantation in Japan in 1998 at Okayama University Hospital. We analyzed the preparation and actual usage of blood products in lung transplantation during this period.
The average number of units of prepared and transfused red cells were 57.4 and 33.5, respectively, with a C/T ratio of 1.73. Average number of units of prepared and transfused fresh frozen plasma were 43.3 and 19.4, and those of platelet concentrate were 27.7 and 19.8, respectively. In double- and single-lung transplantation, the average number of units of transfused red cells, fresh frozen plasma and platelet concentrate were 37.9 and 11.5 (p<0.05), 21.8 and 7.0 (p<0.05), and 22.8 and 4.5 (p<0.05), respectively. In 5 double-lung transplants, more than 100 units of red blood cells were prepared, of which 3 were from cadaveric donors.
It is difficult to predict bleeding volume during lung transplantation due to factors including the degree of adhesion between visceral and parietal pleura. Our analysis suggested that the number of units of blood products required might depend on whether transplantation is single-lung or double-lung, probably indicating that cardiopulmonary bypass usage is a major determinant. Our analysis confirmed that it is important for both transfusion and clinical departments to communicate with each other on a routine basis, and to be prepared to use ABO-mismatched but compatible blood products in order to handle emergency surgery for cadaveric lung transplantation with demand for a large amount of blood products.
