February 1996

Invited Commentary

Author Affiliations

Baltimore, Md

Arch Surg. 1996;131(2):165. doi:10.1001/archsurg.1996.01430140055014

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Many kidney transplant centers include routine administration of FFP or platelet transfusions in the protocol for intraoperative prevention of uremic bleeding. Recipients of kidney transplants are often hypoproteinemic secondary to malnutrition and, despite the presence of peripheral edema, relatively hypovolemic, particularly if they have recently undergone dialysis. Thus, many surgeons believe that FFP is an ideal colloid-based volume expander that also may assist with control of uremic coagulopathy. Unfortunately, administration of FFP is not without risks. Fresh-frozen plasma occasionally leads to allergic reactions and, rarely, to anaphylaxis. The risk of viral transmission with each unit of FFP that is transfused is still significant despite routine viral testing; 1 in 5000 U of blood (or plasma) will result in transmission of hepatitis C virus, and hepatitis B virus or human immunodeficiency virus transmission occurs in one in 200 000 cases. If all 10 000 renal transplant recipients in the United States

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