Intraoperative autologous blood transfusion was effective in a massive blood loss during living-related donor liver transplantation

We have experienced massive blood loss (> 80,000 g) during living-related donor liver transplantation (LRDLT) of a 14-year old girl with biliary atresia. As available homologous blood was not sufficient, we transfused autologous blood (13,400 ml) during operation. Although immunosuppressant was administered to the patient, severe infection did not occur for 10 days after the operation. Cold ischemia time of the graft liver was about 16 hr, but her postoperative liver function was well-maintained. The case suggests that intraoperative autologus blood transfusion is effective if homologous blood is insufficient during LRDLT.