الفهرس 
Anatomical and physiological overview of the liverOnly 14 pages are availabe for public view
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Abstract
Background: Specialized blood components including FFP is required during liver transplantation as the operation is associated with large blood loss and hemostatic disorders. Transfusion is associated with many risks and complications like infections, volume overload, electrolytes imbalance and immunological reactions. Aim of the Work: Our study tried to measure the risk benefit ratio of FFP transfusion and compare between liberal and restrictive policy for FFP transfusion in living donor liver transplantation patients.
Patients and Methods: After approval of the research ethics committee, this study was conducted at Ain Shams University Hospitals retrospectively on 40 patients who underwent living donor liver transplantation between 2014- 2017. In our study 2 groups of patients were compared; each group is formed of 20 patients. In group A (Restrictive policy) FFP transfusion was restricted unless INR is > 2 and platelets transfusion was also restricted unless platelets count is < 50 x 109/L. In group B (liberal policy) fresh frozen plasma was given usually by 2-4 units or by 1:1 ratio with packed RBCs. Also platelets were given by 6-12 units. Results: No significant difference in postoperative INR (P = 0.079) or aPTT (P = 0.50). Also results showed that group B had a significant decrease in postoperative Ca level (P = 0.03), Mg level (P < 0.001) compared to group A and significant increase in length of stay in ICU (P= 0.009) Conclusion: Liberal policy’ for FFP transfusion didn’t show any significant benefit in improving coagulation status or decreasing blood requirement intraoperative. On the other hand it showed some electrolyte imbalance due to Ca and Mg chelating with citrate and also showed significant increase in length of stay in ICU. Recommendations: Further studies on a larger scale of patients are needed to confirm the results obtained by this work.