Author/Authors :
Kasraian, L. Blood Transfusion Research Center- Higher Institute for Research and Education in Transfusion Medicine, Tehran, Iran , Nikeghbalian, S. Department of Hepatobiliary and Transplantation Surgery- Shiraz University of Medical Sciences- Shiraz Transplant Center, Shiraz , Karimi, M. H. Blood Transfusion Research Center- Higher Institute for Research and Education in Transfusion Medicine, Tehran, Iran
Abstract :
Background: Estimation of the amount of blood products required during liver transplantation can help
provision of adequate blood supply, minimize transfusion-associated complications, and plan for preventive
measures in high risk patients.
Objective: To investigate independent predictors of peri-operative blood product transfusion and its impact
on short-term survival of liver transplant recipients.
Methods: In a cross-sectional study, old charts of patients who underwent liver transplantation between
March 2003 and March 2013 at Namazi Hospital, Shiraz, Iran, were reviewed. The mean amount of blood
product utilized during surgery and hospital stay and the related factors, including demographic characteristics,
pre-transplant laboratory data, pre-transplant clinical data, operation data, and post-transplantation
data were recorded.
Results: We studied 1198 patients who underwent liver transplantation. The mean±SD amounts of red
blood cells, fresh frozen plasma, and platelet transfusion during surgery and hospital stay were 2.67±3.5,
2.06±3.8, and 1.6±3.8 units, respectively. The mortality rate was significantly higher in patients who received
high amounts of blood products (p<0.001). The mean amount of blood products’ utilized during
operation was significantly (p<0.001) decreased from 2003 to 2013.The mean amount of packed cell
usage during operation and hospital stay was significantly (p<0.001) correlated with age, technique of
surgery, serum albumin level, cirrhosis, blood urea nitrogen, length of operation, and prothrombin time.
Conclusion: Pre-operative factors may predict blood transfusion requirements in patients undergoing
liver transplantation. Therefore, evaluation of patients before operation should be considered to provide
adequate blood supply and minimize transfusion-associated complications. Understanding pre-operative
factors associated with rate of transfusion may help us to best utilize the limited available blood resources.
Keywords :
Survival rate , Blood loss , Liver transplantation , Blood product transfusion
