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Risk factors and outcomes of massive red blood cell transfusion following living donor liver transplantation
Author(s) -
LI Chuan,
MI Kai,
WEN Tian Fu,
YAN Lu Nan,
LI Bo,
WEI Yong Gang,
YANG Jia Ying,
XU Ming Qing,
WANG Wen Tao
Publication year - 2012
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/j.1751-2980.2011.00570.x
Subject(s) - medicine , blood transfusion , intensive care unit , liver transplantation , platelet , risk factor , surgery , blood product , incidence (geometry) , survival rate , hemoglobin , transplantation , platelet transfusion , physics , optics
OBJECTIVES: To identify the factors influencing blood loss and secondary blood transfusion and to investigate the outcomes of patients who underwent a massive blood transfusion (MBT) following living donor liver transplantation (LDLT). METHODS: Patients who underwent primary adult‐to‐adult right hepatic lobe LDLT were included in the study, and were divided into the MBT group [≥ 6 red blood cell (RBC) units in 24 h] and the non‐massive blood transfusion (NMBT) group (< 6 RBC units in 24 h). All potential risk factors, length of intensive care unit (ICU) stay and long‐term survival rate of the patients in the two groups were analyzed. RESULTS: The data of 181 eligible patients were retrospectively analyzed. A decreased long‐term survival rate, a higher incidence of postoperative infection and prolonged ICU stay were observed in the MBT group. No significant difference was observed in survival rate between patients having platelet transfusion > 2 units and ≤ 2 units. Hemoglobin < 100 g/L, platelet counts < 70 × 10 9 /L, fibrinogen level < 1.5 g/L and history of upper abdominal surgery were found to be independent risk factors. CONCLUSIONS: Blood transfusion during LDLT can be predicted using preoperative variables. Massive RBC transfusion may lead to poor long‐term survival, higher postoperative infection rate and prolonged ICU stay. Platelet transfusion may not be a risk factor for long‐term survival.