The Influence of Central Venous Pressure on Blood Loss During Liver Transplantation

Introduction: Significant blood loss during liver transplantation (OLTx) is a risk factor of impaired graft function and recipient death in early postoperative period. Maintaining low central venous pressure (CVP) is one of possible methods of reducing blood loss during the operation. However opinions on effectiveness of this proceeding are contrary. The aim of the study was to analyse the influence of CVP values during initial stage of operation on blood loss during liver transplantation. Methods: 111 recipients after 116 consecutive OLTx performed between 2005 and 2011 was analyzed retrospectively. Mean recipients age was 47.2±12.8, MELD score - 16.8±7.3.In 113 cases (97.4%) venous anastomosis was performed using Piggy-back method and in 3 (2.6%) - classical method. Analysis of correlation between CVP values in initial stage of operation and blood loss assessed by measuring the volume of blood cells concentrate recovered from operating field was done. Results: Mean initial CVP was 17.9±6.7 (range 3-40) cmH2O and volume of blood cells concentrate recovered by cell-saver - 1736±1415 ml. There was no correlation between initial CVP and volume of blood cells concentrate (R=-0.026, p=0,77). Blood loss did not statistically differ between groups of patients with CVP ≤12cmH2O (24 OLTx - 20,7%) and >12 cmH2O (92 OLTx - 79,3%). Conclusion: High values of the central venous pressure do not significantly increase the risk of blood loss during liver transplantation.