World Journal of Surgery

, Volume 36, Issue 10, pp 2436–2442 | Cite as

Storage Age of Transfused Red Blood Cells During Liver Transplantation and Its Intraoperative and Postoperative Effects

  • Jun Chen
  • Terry Singhapricha
  • Masood Memarzadeh
  • Alyssa Ziman
  • Shan Yuan
  • Ke-qin Hu
  • Randolph H. Steadman
  • Ronald W. Busuttil
  • Victor W. XiaEmail author



Recent studies suggest that the storage age of red blood cells (RBCs) may be associated with morbidity and mortality in surgical patients. We studied perioperative effects of RBC storage age in patients undergoing orthotopic liver transplant (OLT).


Adult patients who received ≥5 U of RBCs during OLT between January 2004 and June 2009 were studied. The subjects were divided into two groups according to the mean storage age of RBCs they received: new or old RBCs (stored ≤14 or >14 days, respectively). Effects of storage age of transfused RBCs during OLT on intraoperative potassium (K+) concentrations, incidence of hyperkalemia (K+ ≥5.5 mmol/L), postoperative morbidity, and patient and graft survival were studied.


The mean serum K+ concentrations and the incidence of hyperkalemia during OLT were significantly associated with storage age of the RBCs. Logistic analysis showed that storage age of RBCs was an independent risk factor for intraoperative hyperkalemia (odds ratios 1.067–1.085, p < 0.001) in addition to baseline K+ concentration and units of RBCs transfused. Patient and graft survival and postoperative morbidity including postoperative ventilation, reoperation, acute renal dysfunction defined by the RIFLE criteria was not associated with old RBCs.


Transfusion of RBCs stored for a longer time was associated with intraoperative hyperkalemia but not with postoperative adverse outcomes in adult OLT. Prevention and treatment of potentially harmful hyperkalemia should be considered when old RBCs are administered.


Graft Survival Orthotopic Liver Transplantation Storage Duration Acute Renal Injury Packed RBCs 
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Conflict of interest

There are no conflicting interests or financial involvements in this study for any of the authors.


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Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Jun Chen
    • 1
    • 4
  • Terry Singhapricha
    • 1
  • Masood Memarzadeh
    • 1
  • Alyssa Ziman
    • 3
  • Shan Yuan
    • 3
  • Ke-qin Hu
    • 5
  • Randolph H. Steadman
    • 1
  • Ronald W. Busuttil
    • 2
  • Victor W. Xia
    • 1
    Email author
  1. 1.Department of Anesthesiology, Ronald Reagan UCLA Medical CenterDavid Geffen School of Medicine at UCLALos AngelesUSA
  2. 2.Department of SurgeryRonald Reagan UCLA Medical CenterLos AngelesUSA
  3. 3.Division of Transfusion Medicine, Department of Pathology and Laboratory MedicineRonald Reagan UCLA Medical CenterLos AngelesUSA
  4. 4.Department of AnesthesiologyTianjin Huanhu HospitalTianjinPeople’s Republic of China
  5. 5.Division of GastroenterologyUniversity of California, Irvine Medical CenterOrangeUSA

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