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Hepatology International

, Volume 7, Issue 3, pp 901–909 | Cite as

The effects of intraoperative cryoprecipitate transfusion on acute renal failure following orthotropic liver transplantation

  • Shuang Liu
  • Xiaoliang Wang
  • Yuanshan Lu
  • Tao Li
  • Zijun Gong
  • Tao Sheng
  • Bin Hu
  • Zhihai Peng
  • Xing Sun
Original Article

Abstract

Purpose

The definition of risk factors associated with acute renal failure (ARF) following orthotropic liver transplantation (OLT) is still controversial. Cryoprecipitate, which can supply fibrinogen and other coagulation factors, is widely used in OLT. However, the effects of intraoperative cryoprecipitate transfusion on ARF following OLT remain unclear.

Methods

In a series of 389 adult patients who received grafts from deceased donors and underwent their first OLT, the clinical correlation between intraoperative cryoprecipitate transfusion and ARF following OLT was retrospectively studied after adjusting for potential confounders. The distribution of ARF and the causes of death within the first year after OLT were also compared separately in patients with and without cryoprecipitate transfusion.

Results

The incidence of ARF in patients with cryoprecipitate transfusion was significantly higher than in patients without cryoprecipitate transfusion (15.9 vs. 7.8 %, p = 0.012). A nonlinear relationship between intraoperative cryoprecipitate transfusion and ARF following OLT was observed. The risk of ARF increased with the cryoprecipitate transfusion level up to the turning point (16 U) (adjusted OR 1.1, 95 % CI 1.1–1.2; p < 0.001). When the cryoprecipitate level exceeded 16 U, the level of cryoprecipitate transfusion was not associated with the risk of ARF (OR 0.95, 95 % CI 0.85–1.1; p = 0.319). Deaths within the first year after the operation occurred more frequently in cases with cryoprecipitate transfusion (22.9 vs. 14.2 %, p = 0.029).

Conclusions

These findings suggested that intraoperative cryoprecipitate transfusion is associated with ARF following OLT. Cryoprecipitate transfusion during OLT should be performed carefully until more convincing evidence has been found.

Keywords

Transfusion Cryoprecipitate Acute renal failure Liver transplantation 

Notes

Acknowledgements

We gratefully acknowledge Prof. Changzhong Chen from Harvard Medical School for the assistance with statistics. This work was supported by a grant from the National Natural Science Foundation of China (81170445).

Conflict of interest

Shuang Liu, Xiaoliang Wang, Yuanshan Lu, Tao Li, Zijun Gong, Tao Sheng, Bin Hu, Zhihai Peng and Xing Sun declare that they have no conflicts of interest.

Compliance with Ethics Requirements

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Due to the retrospective nature of the study, this article did not involve any studies with human or animal subjects. National legislation and the ethics committee of Shanghai First People’s Hospital approved this retrospective study.

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Copyright information

© Asian Pacific Association for the Study of the Liver 2013

Authors and Affiliations

  • Shuang Liu
    • 1
  • Xiaoliang Wang
    • 1
  • Yuanshan Lu
    • 2
  • Tao Li
    • 1
  • Zijun Gong
    • 1
  • Tao Sheng
    • 1
  • Bin Hu
    • 3
  • Zhihai Peng
    • 1
  • Xing Sun
    • 1
  1. 1.Department of General Surgery, Shanghai First People’s Hospital, School of MedicineShanghai Jiao Tong UniversityShanghaiChina
  2. 2.Department of Transfusion, Shanghai First People’s Hospital, School of MedicineShanghai Jiao Tong UniversityShanghaiChina
  3. 3.Department of Gastroenterology, Shanghai First People’s Hospital, School of MedicineShanghai Jiao Tong UniversityShanghaiChina

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