Risk factors associated with blood transfusion in liver transplantation

To explore preoperative and operative risk factors for red blood cell (RBC) transfusion requirements during liver transplantation (LT) and up to 24 h afterwards. We evaluated the associations between risk factors and units of RBC transfused in 176 LT patients using a log-binomial regression model. R...

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Autores: Pérez, Lourdes, Sabaté Pes, Antoni, Gutierrez, Rosa, Caballero Milán, Marta, Pujol, Roger, Llaurado, Sandra, Peñafiel, Judith, Hereu, Pilar, Blasi Ibáñez, Annabel
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/215736
Acceso en línea:https://hdl.handle.net/2445/215736
Access Level:acceso abierto
Palabra clave:Transfusió de sang
Trasplantament hepàtic
Blood transfusion
Hepatic transplantation
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spelling Risk factors associated with blood transfusion in liver transplantationPérez, LourdesSabaté Pes, AntoniGutierrez, RosaCaballero Milán, MartaPujol, RogerLlaurado, SandraPeñafiel, JudithHereu, PilarBlasi Ibáñez, AnnabelTransfusió de sangTrasplantament hepàticBlood transfusionHepatic transplantationTo explore preoperative and operative risk factors for red blood cell (RBC) transfusion requirements during liver transplantation (LT) and up to 24 h afterwards. We evaluated the associations between risk factors and units of RBC transfused in 176 LT patients using a log-binomial regression model. Relative risk was adjusted for age, sex, and the model for end-stage liver disease score (MELD) (adjustment 1) and baseline hemoglobin concentration (adjustment 2). Forty-six patients (26.14%) did not receive transfusion. Grafts from cardiac-death donors were used in 32.61% and 31.54% of non-transfused and transfused patients, respectively. The transfused group required more reoperation for bleeding (P = 0.035), longer mechanical ventilation after LT (P < 0.001), and longer ICU length of stay (P < 0.001). MELD and hemoglobin concentrations determined RBC requirements. For each unit of increase in the MELD score, 2% more RBC units were transfused, and non-transfusion was 0.83-fold less likely. For each 10-g/L higher hemoglobin concentration at baseline, 16% less RBC transfused, and non-transfusion was 1.95-fold more likely. Ascites was associated with 26% more RBC transfusions. With an increase of 2 mm from the baseline in the A10Fibtem measurement of maximum clot firmness, non-transfusion was 1.14-fold more likely. A 10-min longer cold ischemia time was associated with 1% more RBC units transfused, and the presence of post-reperfusion syndrome with 45% more RBC units. We conclude that preoperative correction of anemia should be included in LT. An intervention to prevent severe hypotension and fibrinolysis during graft reperfusion should be explored.Springer Science and Business Media LLC2024202420242024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion10 p.application/pdfhttps://hdl.handle.net/2445/215736Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1038/s41598-024-70078-2Scientific Reports, 2024, vol. 14, num. 1https://doi.org/10.1038/s41598-024-70078-2cc by-nc-nd (c) Pérez, Lourdes et al, 2024http://creativecommons.org/licenses/by-nc-nd/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2157362026-05-29T05:05:01Z
dc.title.none.fl_str_mv Risk factors associated with blood transfusion in liver transplantation
title Risk factors associated with blood transfusion in liver transplantation
spellingShingle Risk factors associated with blood transfusion in liver transplantation
Pérez, Lourdes
Transfusió de sang
Trasplantament hepàtic
Blood transfusion
Hepatic transplantation
title_short Risk factors associated with blood transfusion in liver transplantation
title_full Risk factors associated with blood transfusion in liver transplantation
title_fullStr Risk factors associated with blood transfusion in liver transplantation
title_full_unstemmed Risk factors associated with blood transfusion in liver transplantation
title_sort Risk factors associated with blood transfusion in liver transplantation
dc.creator.none.fl_str_mv Pérez, Lourdes
Sabaté Pes, Antoni
Gutierrez, Rosa
Caballero Milán, Marta
Pujol, Roger
Llaurado, Sandra
Peñafiel, Judith
Hereu, Pilar
Blasi Ibáñez, Annabel
author Pérez, Lourdes
author_facet Pérez, Lourdes
Sabaté Pes, Antoni
Gutierrez, Rosa
Caballero Milán, Marta
Pujol, Roger
Llaurado, Sandra
Peñafiel, Judith
Hereu, Pilar
Blasi Ibáñez, Annabel
author_role author
author2 Sabaté Pes, Antoni
Gutierrez, Rosa
Caballero Milán, Marta
Pujol, Roger
Llaurado, Sandra
Peñafiel, Judith
Hereu, Pilar
Blasi Ibáñez, Annabel
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Transfusió de sang
Trasplantament hepàtic
Blood transfusion
Hepatic transplantation
topic Transfusió de sang
Trasplantament hepàtic
Blood transfusion
Hepatic transplantation
description To explore preoperative and operative risk factors for red blood cell (RBC) transfusion requirements during liver transplantation (LT) and up to 24 h afterwards. We evaluated the associations between risk factors and units of RBC transfused in 176 LT patients using a log-binomial regression model. Relative risk was adjusted for age, sex, and the model for end-stage liver disease score (MELD) (adjustment 1) and baseline hemoglobin concentration (adjustment 2). Forty-six patients (26.14%) did not receive transfusion. Grafts from cardiac-death donors were used in 32.61% and 31.54% of non-transfused and transfused patients, respectively. The transfused group required more reoperation for bleeding (P = 0.035), longer mechanical ventilation after LT (P < 0.001), and longer ICU length of stay (P < 0.001). MELD and hemoglobin concentrations determined RBC requirements. For each unit of increase in the MELD score, 2% more RBC units were transfused, and non-transfusion was 0.83-fold less likely. For each 10-g/L higher hemoglobin concentration at baseline, 16% less RBC transfused, and non-transfusion was 1.95-fold more likely. Ascites was associated with 26% more RBC transfusions. With an increase of 2 mm from the baseline in the A10Fibtem measurement of maximum clot firmness, non-transfusion was 1.14-fold more likely. A 10-min longer cold ischemia time was associated with 1% more RBC units transfused, and the presence of post-reperfusion syndrome with 45% more RBC units. We conclude that preoperative correction of anemia should be included in LT. An intervention to prevent severe hypotension and fibrinolysis during graft reperfusion should be explored.
publishDate 2024
dc.date.none.fl_str_mv 2024
2024
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/215736
url https://hdl.handle.net/2445/215736
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1038/s41598-024-70078-2
Scientific Reports, 2024, vol. 14, num. 1
https://doi.org/10.1038/s41598-024-70078-2
dc.rights.none.fl_str_mv cc by-nc-nd (c) Pérez, Lourdes et al, 2024
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc-nd (c) Pérez, Lourdes et al, 2024
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 10 p.
application/pdf
dc.publisher.none.fl_str_mv Springer Science and Business Media LLC
publisher.none.fl_str_mv Springer Science and Business Media LLC
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429

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