{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T15:16:29Z","timestamp":1774278989297,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Living donor hepatectomy carries a risk of bleeding, and allogeneic transfusion may cause adverse effects. Autologous blood preparation is therefore considered a safer strategy. While preoperative autologous donation (PAD) is widely used, acute normovolemic hemodilution (ANH) may overcome its limitations and offer a practical alternative. However, evidence supporting ANH in donor surgery remains limited. This study compared the clinical utility of ANH and PAD in living donor hepatectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 60 consecutive cases of living donor right hepatectomy performed between 2017 and 2025. Among them, 58 donors who received either PAD or ANH were compared using 1:2 propensity score matching. Perioperative laboratory values, surgical outcomes, any allogeneic transfusion, and postoperative complications were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No unexpected intraoperative adverse events or allogeneic transfusions occurred. All ANH donors received autologous reinfusion, compared with only 6.5% of PAD donors. After matching, 27 donors (18 PAD, 9 ANH) were analyzed. Whole blood viscosity was higher in the ANH group. Weight\u2010adjusted intraoperative bleeding was lower (2.6 vs. 4.6\u2009mL\/kg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.024;\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.106) and operative time was shorter (321 vs. 390\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.007;\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.077) in the ANH group. Postoperative complication rates were comparable. Area under the curve analysis indicated better preservation of total protein (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.038) and prothrombin time\u2010international normalized ratio (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.010) across the perioperative period in the ANH group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ANH maintained transfusion avoidance and donor safety comparable to PAD while improving operative efficiency, supporting ANH as a safe, effective alternative in living donor right hepatectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.18453","type":"journal-article","created":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:01:17Z","timestamp":1760166077000},"page":"2324-2335","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute normovolemic hemodilution reduces blood loss and streamlines blood management in living donor hepatectomy: A preliminary propensity score\u2010matched analysis"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3681-7736","authenticated-orcid":false,"given":"Taiichi","family":"Wakiya","sequence":"first","affiliation":[{"name":"Division of Gastroenterological, General and Transplant Surgery, Department of Surgery Jichi Medical University  Shimotsuke Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nozomu","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Jichi Medical University  Shimotsuke Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5211-5983","authenticated-orcid":false,"given":"Takahiko","family":"Omameuda","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological, General and Transplant Surgery, Department of Surgery Jichi Medical University  Shimotsuke Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshio","family":"Horiuchi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological, General and Transplant Surgery, Department of Surgery Jichi Medical University  Shimotsuke Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2728-2648","authenticated-orcid":false,"given":"Yuta","family":"Hirata","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological, General and Transplant Surgery, Department of Surgery Jichi Medical University  Shimotsuke Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriki","family":"Okada","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological, General and Transplant Surgery, Department of Surgery Jichi Medical University  Shimotsuke Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2456-0400","authenticated-orcid":false,"given":"Yukihiro","family":"Sanada","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological, General and Transplant Surgery, Department of Surgery Jichi Medical University  Shimotsuke Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuharu","family":"Onishi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological, General and Transplant Surgery, Department of Surgery Jichi Medical University  Shimotsuke Tochigi 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