Liver Transplantation without Perioperative Transfusions Single-Center Experience Showing Better Early Outcome and Shorter Hospital Stay
Background. Significant amounts of red blood cells (RBCs) transfusions are associated with poor outcome after liver transplantation (LT). We report our series of LT without perioperative RBC (P-RBC) transfusions to evaluate its influence on early and long-term outcomes following LT. Methods. A conse...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2013/649209 |
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| author | Nicolás Goldaracena Patricio Méndez Emilio Quiñonez Gustavo Devetach Lucio Koo Carlos Jeanes Margarita Anders Federico Orozco Pablo D. Comignani Ricardo C. Mastai Lucas McCormack |
| author_facet | Nicolás Goldaracena Patricio Méndez Emilio Quiñonez Gustavo Devetach Lucio Koo Carlos Jeanes Margarita Anders Federico Orozco Pablo D. Comignani Ricardo C. Mastai Lucas McCormack |
| author_sort | Nicolás Goldaracena |
| collection | DOAJ |
| description | Background. Significant amounts of red blood cells (RBCs) transfusions are associated with poor outcome after liver transplantation (LT). We report our series of LT without perioperative RBC (P-RBC) transfusions to evaluate its influence on early and long-term outcomes following LT. Methods. A consecutive series of LT between 2006 and 2011 was analyzed. P-RBC transfusion was defined as one or more RBC units administrated during or ≤48 hours after LT. We divided the cohort in “No-Transfusion” and “Yes-Transfusion.” Preoperative status, graft quality, and intra- and postoperative variables were compared to assess P-RBC transfusion risk factors and postoperative outcome. Results. LT was performed in 127 patients (“No-Transfusion” = 39 versus “Yes-Transfusion” = 88). While median MELD was significantly higher in Yes-Transfusion (11 versus 21; P=0.0001) group, platelet count, prothrombin time, and hemoglobin were significantly lower. On multivariate analysis, the unique independent risk factor associated with P-RBC transfusions was preoperative hemoglobin (P<0.001). Incidence of postoperative bacterial infections (10 versus 27%; P=0.03), median ICU (2 versus 3 days; P=0.03), and hospital stay (7.5 versus 9 days; P=0.01) were negatively influenced by P-RBC transfusions. However, 30-day mortality (10 versus 15%) and one- (86 versus 70%) and 3-year (77 versus 66%) survival were equivalent in both groups. Conclusions. Recipient MELD score was not a predictive factor for P-RBC transfusion. Patients requiring P-RBC transfusions had worse postoperative outcome. Therefore, maximum efforts must be focused on improving hemoglobin levels during waiting list time to prevent using P-RBC in LT recipients. |
| format | Article |
| id | doaj-art-20d5b64fb8c44edda02768b26b8aebd7 |
| institution | Kabale University |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-20d5b64fb8c44edda02768b26b8aebd72025-02-03T01:22:30ZengWileyJournal of Transplantation2090-00072090-00152013-01-01201310.1155/2013/649209649209Liver Transplantation without Perioperative Transfusions Single-Center Experience Showing Better Early Outcome and Shorter Hospital StayNicolás Goldaracena0Patricio Méndez1Emilio Quiñonez2Gustavo Devetach3Lucio Koo4Carlos Jeanes5Margarita Anders6Federico Orozco7Pablo D. Comignani8Ricardo C. Mastai9Lucas McCormack10Liver Surgery and Transplantation Unit, Hospital Alemán of Buenos Aires, Avenue Pueyrredón 1640, 1118AAAT Buenos Aires, ArgentinaLiver Surgery and Transplantation Unit, Hospital Alemán of Buenos Aires, Avenue Pueyrredón 1640, 1118AAAT Buenos Aires, ArgentinaLiver Surgery and Transplantation Unit, Hospital Alemán of Buenos Aires, Avenue Pueyrredón 1640, 1118AAAT Buenos Aires, ArgentinaAnesthesiology Service and Transplantation Unit, Hospital Alemán of Buenos Aires, Avenue Pueyrredón 1640, 1118AAAT Buenos Aires, ArgentinaAnesthesiology Service and Transplantation Unit, Hospital Alemán of Buenos Aires, Avenue Pueyrredón 1640, 1118AAAT Buenos Aires, ArgentinaAnesthesiology Service and Transplantation Unit, Hospital Alemán of Buenos Aires, Avenue Pueyrredón 1640, 1118AAAT Buenos Aires, ArgentinaHepatology Service and Transplantation Unit, Hospital Alemán of Buenos Aires, Avenue Pueyrredón 1640, 1118AAAT Buenos Aires, ArgentinaHepatology Service and Transplantation Unit, Hospital Alemán of Buenos Aires, Avenue Pueyrredón 1640, 1118AAAT Buenos Aires, ArgentinaCritical Care Unit, Hospital Alemán of Buenos Aires, Avenue Pueyrredón 1640, 1118AAAT Buenos Aires, ArgentinaHepatology Service and Transplantation Unit, Hospital Alemán of Buenos Aires, Avenue Pueyrredón 1640, 1118AAAT Buenos Aires, ArgentinaLiver Surgery and Transplantation Unit, Hospital Alemán of Buenos Aires, Avenue Pueyrredón 1640, 1118AAAT Buenos Aires, ArgentinaBackground. Significant amounts of red blood cells (RBCs) transfusions are associated with poor outcome after liver transplantation (LT). We report our series of LT without perioperative RBC (P-RBC) transfusions to evaluate its influence on early and long-term outcomes following LT. Methods. A consecutive series of LT between 2006 and 2011 was analyzed. P-RBC transfusion was defined as one or more RBC units administrated during or ≤48 hours after LT. We divided the cohort in “No-Transfusion” and “Yes-Transfusion.” Preoperative status, graft quality, and intra- and postoperative variables were compared to assess P-RBC transfusion risk factors and postoperative outcome. Results. LT was performed in 127 patients (“No-Transfusion” = 39 versus “Yes-Transfusion” = 88). While median MELD was significantly higher in Yes-Transfusion (11 versus 21; P=0.0001) group, platelet count, prothrombin time, and hemoglobin were significantly lower. On multivariate analysis, the unique independent risk factor associated with P-RBC transfusions was preoperative hemoglobin (P<0.001). Incidence of postoperative bacterial infections (10 versus 27%; P=0.03), median ICU (2 versus 3 days; P=0.03), and hospital stay (7.5 versus 9 days; P=0.01) were negatively influenced by P-RBC transfusions. However, 30-day mortality (10 versus 15%) and one- (86 versus 70%) and 3-year (77 versus 66%) survival were equivalent in both groups. Conclusions. Recipient MELD score was not a predictive factor for P-RBC transfusion. Patients requiring P-RBC transfusions had worse postoperative outcome. Therefore, maximum efforts must be focused on improving hemoglobin levels during waiting list time to prevent using P-RBC in LT recipients.http://dx.doi.org/10.1155/2013/649209 |
| spellingShingle | Nicolás Goldaracena Patricio Méndez Emilio Quiñonez Gustavo Devetach Lucio Koo Carlos Jeanes Margarita Anders Federico Orozco Pablo D. Comignani Ricardo C. Mastai Lucas McCormack Liver Transplantation without Perioperative Transfusions Single-Center Experience Showing Better Early Outcome and Shorter Hospital Stay Journal of Transplantation |
| title | Liver Transplantation without Perioperative Transfusions Single-Center Experience Showing Better Early Outcome and Shorter Hospital Stay |
| title_full | Liver Transplantation without Perioperative Transfusions Single-Center Experience Showing Better Early Outcome and Shorter Hospital Stay |
| title_fullStr | Liver Transplantation without Perioperative Transfusions Single-Center Experience Showing Better Early Outcome and Shorter Hospital Stay |
| title_full_unstemmed | Liver Transplantation without Perioperative Transfusions Single-Center Experience Showing Better Early Outcome and Shorter Hospital Stay |
| title_short | Liver Transplantation without Perioperative Transfusions Single-Center Experience Showing Better Early Outcome and Shorter Hospital Stay |
| title_sort | liver transplantation without perioperative transfusions single center experience showing better early outcome and shorter hospital stay |
| url | http://dx.doi.org/10.1155/2013/649209 |
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