Predicting packed red blood cell transfusion in living donor liver transplantation: A retrospective analysis

Background and Aims: Blood transfusion is unpredictable in liver transplantation and is associated with increased patient morbidity, mortality and cost. This retrospective analysis was conducted to detect factors which could predict intraoperative transfusion of more than four units of packed red bl...

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Main Authors: Shweta A Singh, Kelika Prakash, Sandeep Sharma, An Anil, Viniyendra Pamecha, Guresh Kumar, Ajeet Bhadoria
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2019-01-01
Series:Indian Journal of Anaesthesia
Subjects:
Online Access:http://www.ijaweb.org/article.asp?issn=0019-5049;year=2019;volume=63;issue=2;spage=119;epage=125;aulast=Singh
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spelling doaj-c850e760d710437da96673c73d5f92822020-11-25T01:51:37ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172019-01-0163211912510.4103/ija.IJA_401_18Predicting packed red blood cell transfusion in living donor liver transplantation: A retrospective analysisShweta A SinghKelika PrakashSandeep SharmaAn AnilViniyendra PamechaGuresh KumarAjeet BhadoriaBackground and Aims: Blood transfusion is unpredictable in liver transplantation and is associated with increased patient morbidity, mortality and cost. This retrospective analysis was conducted to detect factors which could predict intraoperative transfusion of more than four units of packed red blood cells (PRBCs) during elective living donor liver transplantation (LDLT). Methods: This was a single-centre retrospective study. Demographic, clinical and intraoperative data of 258 adult patients who underwent LDLT from March 2009 to January 2015 were analysed. Univariate and multivariate regression model was used to identify factors responsible for transfusion of more than four PRBCs (defined as massive transfusion [MT]). Results: On univariate regression analysis, preoperative factors like aetiology of liver disease, hypertension, history of spontaneous bacterial peritonitis, low haemoglobin and fibrinogen, high serum bilirubin, high blood urea and creatinine, high model for end-stage liver disease score, portal venous thrombosis, increased duration of surgery and anhepatic phase as well as increased use of other blood products were found to be significantly associated with MT. Multivariate logistic regression analysis revealed that the only independent factor associated with MT was the number of units of fresh frozen plasma transfused (odds ratio = 1.54 [95% CI (1.12–2.12)]). Conclusion: Many factors are responsible for the need for transfusion during LDLT. Preoperative factors alone do not accurately and consistently predict the need for MT as in our study. It is important to be prepared for need for MT during each transplant.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2019;volume=63;issue=2;spage=119;epage=125;aulast=SinghBlood transfusionliver transplantationliving donors
collection DOAJ
language English
format Article
sources DOAJ
author Shweta A Singh
Kelika Prakash
Sandeep Sharma
An Anil
Viniyendra Pamecha
Guresh Kumar
Ajeet Bhadoria
spellingShingle Shweta A Singh
Kelika Prakash
Sandeep Sharma
An Anil
Viniyendra Pamecha
Guresh Kumar
Ajeet Bhadoria
Predicting packed red blood cell transfusion in living donor liver transplantation: A retrospective analysis
Indian Journal of Anaesthesia
Blood transfusion
liver transplantation
living donors
author_facet Shweta A Singh
Kelika Prakash
Sandeep Sharma
An Anil
Viniyendra Pamecha
Guresh Kumar
Ajeet Bhadoria
author_sort Shweta A Singh
title Predicting packed red blood cell transfusion in living donor liver transplantation: A retrospective analysis
title_short Predicting packed red blood cell transfusion in living donor liver transplantation: A retrospective analysis
title_full Predicting packed red blood cell transfusion in living donor liver transplantation: A retrospective analysis
title_fullStr Predicting packed red blood cell transfusion in living donor liver transplantation: A retrospective analysis
title_full_unstemmed Predicting packed red blood cell transfusion in living donor liver transplantation: A retrospective analysis
title_sort predicting packed red blood cell transfusion in living donor liver transplantation: a retrospective analysis
publisher Wolters Kluwer Medknow Publications
series Indian Journal of Anaesthesia
issn 0019-5049
0976-2817
publishDate 2019-01-01
description Background and Aims: Blood transfusion is unpredictable in liver transplantation and is associated with increased patient morbidity, mortality and cost. This retrospective analysis was conducted to detect factors which could predict intraoperative transfusion of more than four units of packed red blood cells (PRBCs) during elective living donor liver transplantation (LDLT). Methods: This was a single-centre retrospective study. Demographic, clinical and intraoperative data of 258 adult patients who underwent LDLT from March 2009 to January 2015 were analysed. Univariate and multivariate regression model was used to identify factors responsible for transfusion of more than four PRBCs (defined as massive transfusion [MT]). Results: On univariate regression analysis, preoperative factors like aetiology of liver disease, hypertension, history of spontaneous bacterial peritonitis, low haemoglobin and fibrinogen, high serum bilirubin, high blood urea and creatinine, high model for end-stage liver disease score, portal venous thrombosis, increased duration of surgery and anhepatic phase as well as increased use of other blood products were found to be significantly associated with MT. Multivariate logistic regression analysis revealed that the only independent factor associated with MT was the number of units of fresh frozen plasma transfused (odds ratio = 1.54 [95% CI (1.12–2.12)]). Conclusion: Many factors are responsible for the need for transfusion during LDLT. Preoperative factors alone do not accurately and consistently predict the need for MT as in our study. It is important to be prepared for need for MT during each transplant.
topic Blood transfusion
liver transplantation
living donors
url http://www.ijaweb.org/article.asp?issn=0019-5049;year=2019;volume=63;issue=2;spage=119;epage=125;aulast=Singh
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