The patients assigned to the restrictive group will receive transfusion once the hemoglobin concentration falls below 6.0 g per deciliter, with a target hemoglobin range of 7.5 to 8.0 g per deciliter. Patients assigned to the liberal group will receive transfusion once the hemoglobin concentration falls below 8.0 g per deciliter, with a target hemoglobin range of 9.0 to 10.0 g per deciliter. The primary outcome: Survival rate in six months after randomization. Secondary outcomes: Incidence of perioperative complications, including sepsis , pulmonary complications, portal vein thrombosis, hepatic artery thrombosis and transfusion-related adverse events. Intraoperative blood loss, intraoperative blood transfusion amount, postoperative blood transfusion amount in 7 days after surgery, postoperative inflammatory reaction, mechanical ventilation time in the intensive care unit, lengths of stay in the intensive care unit and the hospital，and hospitalization expenses.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
488
Transfusion will start when the hemoglobin concentration falls below 6.0 g/dL
Renji Hospital affliated to Shanghai Jiaotong University School of Medicine
Shanghai, Shanghai Municipality, China
RECRUITINGSurvival rate
Time frame: up to 6 months after randomization
Amount of intraoperative blood transfusion
Time frame: during surgery
Amount of blood transfusion during perioperative period
Time frame: up to 7 days after surgery
Heart rate during surgery
Time frame: during surgery
Blood pressure during surgery
Time frame: during surgery
Arterial partial pressure of oxygen during surgery
Time frame: during surgery
Plasma lactic acid concentration during surgery
Time frame: during surgery
Oxygen uptake rate during surgery
Time frame: during surgery
Daily score on Pediatric end-stage liver disease (PELD) assessment
Time frame: up to 7 days after randomization
Length of Mechanical Ventilation in the intensive care unit
Time frame: at discharge, an average of 2 weeks
Lengths of stay in the intensive care unit
Time frame: at discharge, an average of 2 weeks
Proportion of patients who need a second hepatic surgery
Time frame: up to 7 days after randomization
Hospitalization Days
Time frame: at discharge, an average of 2 weeks
Out of pocket expenditure for hospitalization
Time frame: at discharge, an average of 2 weeks
Incidence of severe postoperative complications before discharge
Postoperative complications include sepsis , pulmonary complications, portal vein thrombosis, hepatic artery thrombosis and transfusion-related adverse events.
Time frame: from end of surgery till at discharge, an average of 2 weeks
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