Huge amounts of blood needed for surgery?

Factual Questions
1

I just received a solicitation from the Red Cross talking about the great need for blood. They specifically mention that

Holy Mazoley. My understanding is that a unit is a pint. That’s over 7 *gallons * of blood. The average person has something like 10 pints in their whole body. Can someone in the medical profession give me a layman’s explanation of why there is so much blood loss in such a surgery, and in a more practical vein (no pun intended), where does it all go? To my knowledge there is no “blood disposal drain” on the OR floor.

2

Transplant surgeries often take a long time 6-8 hours and usually involve organs with alot of blood flow.

3

That seems kinda high. This Red Cross site

I suppose it’s possible, but it seems like many surgeries would require less.

4

My mother want to donate her own blood for her knee replacement surgery. I’m pretty sure she only had to do it three times.

5

I’d expect it to go into a suction tube, wielded by a surgery nurse. Can anyone confirm or correct? Sixty units does seem high, though.

6

I can confirm. It goes right into a suction tube and ends up in a cannister of medical waste. An operating room in the US cannot have a floor drain, as that is a violation of sterile protocol.

Also, the reason transplant surgery requires so much blood on hand is that they have to connect the transplanted organ to the host’s vasculature. This requires intricate anastomotic surgery (surgically connecting all the little arteries and veins of the recipient to the cut off veins/arteries of the new donor organ).

7

Remember that more than red blood cells can be needed by a patient having surgery, e.g. blood platelets (to help the blood clot), various clotting factors, etc.

For liver surgery and/or transplant in particular, there is often huge consumption of the patient’s platelets and clotting factors. Hence, the need for those types of transfusions (and, as mentioned, it is awfully bloody surgery so that good old red cells are needed as well).

8

In a lot of surgeries these days, they use an auto-transfuser attached to the suction system. I filters the blood and they can re-transfuse the patient’s own blood immediately during the surgery.

9

This is what I came in to say.

Early liver tx used more blood, even as much as 60 units. The surgery took longer because no one had experience with it. As more surgeons became proficient, time needed, and necessary resources lessened.

I believe the ARC is using those older numbers.

Even so, liver surgery is very bloody.

10

I’ve often wondered about this. I’ve had several operations in the past 5 years, most of them laproscopic (sp) but 3 of them full open.

Did I receive blood? How would I know?

11

Anecdotal, but still:
When my left kidney was removed three years ago, the doc told me I lost a grand total of about 6oz. of liquid. I was informed that they burn every blood vessel, nerve or whatever as they cut open, to minimize loss of fluids, as patients then recover more quickly (I was out of the hospital three days after surgery).

Of course, a transplant will take longer time and be more messy and they can’t burn everything, since some vessels need to be reattached.

12

Presumably, you signed some consent pre-op allowing them to transfuse you if necessary. To find out if they actually needed to give you blood, you would need to read the operative report. This should be available through the medical records office of the hospital.

13

I was denied permission to watch my father’s liver transplant because it was considered too upsetting for a lay person on account of “the gushiness.”