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Alloimmunization to red blood cell antigens affects clinical outcomes in liver transplant patients
Author(s) -
Boyd Scott D.,
Stenard Fabien,
Lee Donald K.K.,
Goodnough Lawrence T.,
Esquivel Carlos O.,
Fontaine Magali J.
Publication year - 2007
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21241
Subject(s) - medicine , liver transplantation , blood transfusion , regimen , retrospective cohort study , organ transplantation , proportional hazards model , hazard ratio , surgery , transplantation , gastroenterology , confidence interval
Transfusion therapy of liver transplant patients remains a challenge. High volumes of intraoperative blood transfusion have been shown to increase the risk of poor graft or patient survival. We conducted a retrospective study of 209 consecutive liver transplant cases at our institution. Only patients receiving their first liver transplant, with no other simultaneous organ transplants, were included. Cox proportional hazard modeling was used to identify clinical variables correlated with postoperative patient mortality. Statistically significant variables for poor patient survival were the number of red blood cell and plasma units transfused, a history of red blood cell alloantibodies, and the immunosuppressive regimen used. History of pregnancy also approached statistical significance but was less robust than the other 3 variables. Our findings suggest that blood transfusion and immune modulation greatly affect the survival of patients after liver transplantation. Liver Transpl 13:1654–1661, 2007. © 2007 AASLD.