Survival rate changes with transfusion of blood products during liver transplantation

  • Luc Massicotte
  • Marie-Pascale Sassine
  • Serge Lenis
  • Robert F. Seal
  • André Roy
General anesthesia

Abstract

Purpose

To determine whether red blood cell (RBC) or plasma transfusion is associated with the one-year survival rate variation previously detected in liver transplantation.

Methods

A retrospective study of 206 consecutive liver transplantations was undertaken. Intraoperative transfusions of blood products were identified. Twenty-seven variables were studied using univariate and multivariate analyses to identify factors that were associated significantly with survival rate. For analysis of one-year survival, the cases were studied according to the transfused blood products. Patients were stratified according to the degree of RBC and plasma transfusion into four groups: more than four units of RBC, one to four units of RBC, plasma transfusion only, and no plasma or RBC transfusions.

Results

Patients received an average of 2.8 ± 3.5 units of RBC and 4.1 ± 4.1 units of plasma. Thirty-two percent of the patients did not receive any RBC transfusion and 19.4% did not receive any blood products. The one-year survival rate was 81.9% for all patients and 97.4% for patients without any transfusions. Of the 27 variables evaluated, only RBC and plasma transfusions were associated with significant decrease in the one-year survival rate, which was seen in the group who received only plasma (76.9%, P = 0.014) and the group who received more than four units of RBC (62.5%, P < 0.0001).

Conclusion

Although we cannot demonstrate causality, our analysis shows that our one-year survival rate following liver transplantation decreased significantly with the intraoperative transfusion of any amount of plasma or more than four units of RBC.

Le taux de survie change avec la transfusion de produits sanguins pendant la transplantation hépatique

Résumé

Objectif

Déterminer si la transfusion de globules rouges (GR) ou de plasma est associée à la variation du taux de survie d’un an déjà détectée pour une transplantation hépatique.

Méthode

Une étude rétrospective de 206 transplantations hépatiques consécutives a été menée. Les transfusions peropératoires de produits sanguins ont été recensées. Nous avons étudié 27 variables par des d’analyses à une ou plusieurs variables pour repérer les facteurs associés de façon significative au taux de survie. Pour l’analyse du taux de survie d’un an a été faite selon les produits sanguins transfusés. Les patients ont été stratifiés en quatre groupes d’après le degré de transfusion de GR et de plasma: plus de quatre unités de GR, de une à quatre unités, transfusion de plasma seulement et aucune transfusion.

Résultats

Les patients ont reçu en moyenne 2,8 ± 3,5 unités de GR et 4,1 ± 4,1 unités de plasma. Trente-deux pour cent n’ont reçu aucune transfusion de GRet 19,4% aucun produit sanguin. Le taux de survie d’un an a été de 81,9% pour tous les patients et de 97,4% pour ceux qui n’ont eu aucune transfusion. Des 27 variables évaluées, seules les transfusions de Gr et de plasma ont été associées à une baisse significative du taux de survie d’un an, notée chez les patients qui ont reçu du plasma seulement (76,9%, P = 0,014) ou plus de quatre unités de GR (62,5%, P < 0,0001).

Conclusion

Sans pouvoir établir de causalité, notre analyse montre que le taux de survie d’un an après une transplantation hépatique diminue significativement avec la transfusion peropératoire de toute quantité de plasma ou de plus de quatre unités de GR.

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Copyright information

© Canadian Anesthesiologists 2005

Authors and Affiliations

  • Luc Massicotte
    • 1
  • Marie-Pascale Sassine
    • 1
  • Serge Lenis
    • 1
  • Robert F. Seal
    • 3
  • André Roy
    • 2
  1. 1.From the Departments of AnesthesiologyHôpital St-Luc — CHUMMontréalCanada
  2. 2.From the Departments of Anesthesiology and SurgeryCentre Hospitalier de l’Université de Montréal (CHUM)Montréal
  3. 3.and the Department of Anesthesiology and Pain MedicineUniversity of AlbertaEdmontonCanada

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