Premium
Balanced blood product transfusion during liver transplantation
Author(s) -
Hogen Rachel,
Dhanireddy Kiran,
Clark Damon,
Biswas Subarna,
DiNorcia Joseph,
Brown Niquelle,
Yee Jonson,
Cobb Joseph Perren,
Strumwasser Aaron
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13191
Subject(s) - medicine , blood product , packed red blood cells , fresh frozen plasma , liver transplantation , confidence interval , surgery , blood transfusion , retrospective cohort study , platelet , anesthesia , transplantation
This study was conducted to determine whether an intra‐operative ratio of at least 1:1:2 of fresh frozen plasma ( FFP ):platelets ( PLT s):packed red blood cells ( pRBC s) improves outcomes in orthotopic liver transplantation ( OLT ). Methods A single‐center, retrospective study of deceased donor OLT recipients ( MELD ≥15) requiring intra‐operative pRBC transfusion (years 2013‐2016). Patients were grouped into those receiving an intra‐operative ratio of ≥1:1:2 of FFP : PLT s: pRBC s vs ratios <1:1:2. Results Patients in ≥1:1:2 group (n = 150) and patients in <1:1:2 group (n = 80) were matched for baseline characteristics ( P > .05). Patients in the ≥1:1:2 group had lower pRBC and intra‐operative blood product requirements (11 ± 0.5 vs 19 ± 1.4 units, P < .001, and 33 ± 1.3 vs 43 ± 3.3 units, P = .006, respectively), improved 1‐month mortality (0 vs 8%, P = .002), improved 1‐year survival ( P = .004), less intra‐operative cardiac arrest (3% vs 10%, P = .03), and shorter operating room time (389 ± 7.2 vs 431 ± 17.2 minutes, P = .03). After multivariate adjustment for baseline and intra‐operative variables, balanced blood product transfusion ( BBPT ) was significantly associated with less intra‐operative pRBC transfusion (95% confidence interval: 0.60‐0.72). Conclusion Balanced blood product transfusion is associated with reduced transfusion requirements in OLT .