Table 2.

Consensus proposal of the ISGLS for the definition and severity grading of post-hepatectomy haemorrhage (PHH)

Definition	Post-hepatectomy haemorrhage (PHH) is defined as a drop of haemoglobin level >3 g/dl after the end of surgery compared to postoperative baseline level and/or any postoperative transfusion of PRBCs for a falling hemoglobin and/or the need for invasive re-intervention (e.g. embolization or re-laparotomy) to stop bleeding.
	To diagnose PHH (and to exclude other sources of haemorrhage) evidence of intraabdominal bleeding should be obtained such as frank blood loss via the abdominal drains if present (e.g. haemoglobin level in drain fluid >3 g/dl) or detection of an intra-abdominal haematoma or active haemorrhage by abdominal imaging (ultrasound, CT, angiography). Patients who are transfused immediately postoperatively for intra-operative blood loss by a maximum of two units of PRBCs (i.e. who do not have evidence of active haemorrhage) are not diagnosed with PHH.
Grading	A	PHH requiring transfusion of up to 2 units of PRBCs
	B	PHH requiring transfusion of >2 units of PRBCs but manageable without invasive intervention
	C	PHH requiring radiological interventional treatment (e.g. embolization) or re-laparotomy