Successful Intraoperative Management to Minimize Blood Loss Using the Combination of Tranexamic Acid and Hemocoagulase for Jehovah’s Witnesses Patient with Liver Cirrhosis

ABSTRACT

A 78-year-old Jehovah’s Witnesses women with hepatitis B viral liver cirrhosis scored as Child-Pugh A was scheduled for debulking operation of peritoneal carcinomatosis due to right ovarian cancer. Despite the need for preoperative strategies for correction of anemia and coagulopathy due to the risk of significant intraoperative hemorrhage, preoperative management was missing. In addition, she exhibited preoperative hemoglobin, hematocrit levels, and platelet count of 10.5 g/dL, 33.6%, and 85,000/μL, respectively. To minimize intraoperative blood loss, we used the combination of tranexamic acid and hemocoagulase, intraoperative blood loss counted about 700 mL, and the immediate postoperative hemoglobin was 9.0 g/dL. She recovered well without any anemic complications or thromboembolic events.