Assessment of the need for routine intraoperative cell salvage in liver transplantation.

PURPOSE: This study aimed to assess the necessity of routine intraoperative cell salvage in liver transplantations. METHODS: A total of 327 liver transplants performed between 2014 and 2016 was included in the analysis. Patient data, including pre-transplant examinations, intraoperative red blood cell transfusions, and procedural information, were collected. RESULTS: The median age of the patients was 54 years old, with 67% (219) being male. The most prevalent ABO blood type was O, accounting for 48% (155) of cases. The leading causes of liver disease were hepatitis C (113 cases, 34.6%) and alcohol-related liver disease (97 cases, 29.7%). Out of the 327 liver transplants, allogeneic red blood cell transfusions were administered in 110 cases (34%) with a median of two units of red blood cells per case. Cell salvage was employed in 237 transplants (73%), and successful blood recovery was achieved in 221 cases (93%). Among the group that recovered more than 200 mL of blood, the median volume of recovered blood was 417 mL, with no transfusion of allogeneic blood required. A total of 90 transplants was performed without utilizing cell salvage, and, among these cases, 19 required blood transfusions, with a median of zero units transfused. CONCLUSIONS: This study suggests that routine cell salvage is unnecessary for all liver transplantations. The most suitable indication for its use is in patients presenting with portal vein thrombosis and abnormal creatinine levels.

Assessment of the need for routine intraoperative cell salvage in liver transplantation

Purpose: This study aimed to assess the necessity of routine intraoperative cell salvage in liver transplantations. Methods: A total of 327 liver transplants performed between 2014 and 2016 was included in the analysis. Patient data, including pre-transplant examinations, intraoperative red blood cell transfusions, and procedural information, were collected. Results: The median age of the patients was 54 years old, with 67% (219) being male. The most prevalent ABO blood type was O, accounting for 48% (155) of cases. The leading causes of liver disease were hepatitis C (113 cases, 34.6%) and alcohol-related liver disease (97 cases, 29.7%). Out of the 327 liver transplants, allogeneic red blood cell transfusions were administered in 110 cases (34%) with a median of two units of red blood cells per case. Cell salvage was employed in 237 transplants (73%), and successful blood recovery was achieved in 221 cases (93%). Among the group that recovered more than 200 mL of blood, the median volume of recovered blood was 417 mL, with no transfusion of allogeneic blood required. A total of 90 transplants was performed without utilizing cell salvage, and, among these cases, 19 required blood transfusions, with a median of zero units transfused. Conclusions: This study suggests that routine cell salvage is unnecessary for all liver transplantations. The most suitable indication for its use is in patients presenting with portal vein thrombosis and abnormal creatinine levels.

Fatores associados à vulnerabilidade da não adesão do distanciamento social de trabalhadores na COVID-19 / Factors Associated With the Vulnerability of Non-Adhrence to the Social Distancing of Workers in COVID-19

Objetivo: refletir sobre os fatores associado as vulnerabilidades de diferentes domínios como individual, social e programática de trabalhadores informais e os impactos da não adesão do distanciamento social nesse cenário de pandemia. Método: Estudo Reflexivo overview, que contou com o auxílio de publicações recentes relacionadas a esta proposta, sobretudo de pesquisas realizadas no Brasil e em outros países. Resultados: O estudo permitiu tecer reflexões sobre o impacto da pandemia nos trabalhadores informais associados vulnerabilidades e seus domínios Considerações finais: Esta reflexão pode contribuir para repensar a saúde e segurança e fomentar reflexões críticas acerca da desigualdade social no enfrentamento da pandemia.

Objective: to reflect on the factors associated with the vulnerabilities of different domains such as individual, social, and programmatic of informal workers and the impacts of non-adherence to social distancing in this pandemic scenario. Method: Reflective Study Overview, which had the help of recent publications related to this proposal, especially research conducted in Brazil and other countries. Results: The study allowed reflections on the impact of the pandemic on informal workers associated with vulnerabilities and their domains Final considerations: This reflection can contribute to rethink health and safety and foster critical reflections on social inequality in tackling the pandemic.