World J Gastrointest Surg. May 27, 2026; 18(5): 119105 Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.119105
Blood conservation strategies in liver transplantation: Past, present, and future
Srilaxmi Sarangi, Yajnadatta Sarangi
Srilaxmi Sarangi, Department of Transfusion Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
Yajnadatta Sarangi, Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
Author contributions: Sarangi S and Sarangi Y designed the concept, revised and edited the manuscript; Sarangi S performed the literature search and wrote the manuscript.
AI contribution statement: The authors used AI (ChatGPT/OpenAI) to improve grammar, polish language and readability. No AI tools were used in the study design, analysis, interpretation or generating any portion of the manuscript. None of the images and tables was generated by AI. The authors reviewed and approved the final manuscript and take full responsibility for its content.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Corresponding author: Yajnadatta Sarangi, Assistant Professor, Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raibareli Road, Lucknow 226014, Uttar Pradesh, India. yajnadattas3@gmail.com
Received: January 20, 2026 Revised: February 5, 2026 Accepted: March 5, 2026 Published online: May 27, 2026 Processing time: 127 Days and 22 Hours
Core Tip
Core Tip: Blood conservation in liver transplantation is critical to reduce transfusion-related morbidity, cost, and immunological complications. Effective strategies begin preoperatively with optimization of anemia, correction of coagulopathy, and patient selection. Intraoperative measures include low central venous pressure anesthesia, meticulous surgical technique, use of cell salvage, point-of-care coagulation monitoring, and targeted component therapy rather than empirical transfusion. Pharmacological adjuncts such as antifibrinolytics further reduce blood loss. Postoperatively, restrictive transfusion thresholds and ongoing hemostatic monitoring are essential. A multidisciplinary, protocol-driven approach significantly improves outcomes and graft survival.
