ADVANTAGES OF PIGGYBACK TECHNIQUE IN

INTRAOPERATIVE TRANSFUSION FLUID

CONSUMPTIONIN LIVER TRANSPLANTATION; A
SERIES OF 120 CASES

Malek-Hosseini SA, Salahi H, Bahador A, Saberi Firoozi MR,

Mehdizadeh AR, Razmkon A
Southern Organ Transplant Center, Shiraz IRAN

The piggyback technique was first described in adult liver

transplantation in 1989, although it has been used in conjunction
with venous bypass. We compared the use of intraoperative blood
product and fluid requirement among patients managed with and
without bypass with those in whom the piggyback technique was
used. 130 consecutive liver transplants were performed between
April 14, 1993 and June 26, 2004, in Shiraz (Southern Iran) organ
transplant center in which 120 cases used piggyback technique. We
studied the last 40 cases in this investigation. Operation time, fluid
consumption and operative outcome were calculated in a mean
follow up period of 9 months. 92% of patients were alive with only
one operative mortality at the time of study. The mean number of
packed RBC units consumed intraoperatively per case was 8.3±3.6,
and 3.2±1.6 units of crystalloids were used. Mean Operation time
was 125±50 minutes. Graft and patient survival during this period
was 92% and 92%; respectively. The piggyback technique requires
a longer operation time but offers the advantage of reducing RBC
requirements and preventing severe hemodynamic instability by
virtue of intraoperative fluids.