Transfusion Management and Immunohematologic Complications in Liver Transplantation: Experience of a Single Institution

Overview

Journal Transfus Med Hemother

Specialty Hematology

Date 2015 May 12

PMID 25960710

Citations 3

Authors

Pilar Solves

Nelly Carpio

Federico Moscardo

Aima Lancharro

Isabel Cano

Angel Moya

Rafael Lopez-Andujar

Miguel Angel Sanz

Affiliations

Soon will be listed here.

Abstract

Objective: Liver transplantation (LT) has traditionally been associated with major blood loss and consequently high blood transfusion requirements. Our objective was to analyze transfusion management and incidence of immunohematologic complications in patients undergoing LT at our institution.

Methods: A retrospective analysis of immunohematologic events and transfusion outcomes was carried out at La Fe University Hospital in Valencia. Data from 654 patients were reviewed: 654 underwent only one LT while 36 underwent second LT.

Results: Patients received a median of 3 red blood cell (RBC) concentrates, 2 platelets concentrates (PCs) and 2 fresh frozen plasma units (FFPs). Variables significantly influencing RBC transfusions were: the MELD score, hemoglobin levels, and the platelet counts before LT. 27 patients (4.1%) had a positive antibody screening before transplant. Immunohematologic events occurred in 8% of the patients, mostly in the first month after LT, and involved hemolysis in 13 cases. Mortality was significantly higher in patients developing immunohematologic disorders (42.8 vs. 18.3%; p < 0.001). In the multivariable analysis, only ABO minor incompatibility between donor and recipient significantly increased the appearance of immunohematologic incidences (OR 4.92, 95% CI 2.31-10.50; p < 0.001).

Conclusion: Transfusion management of patients that underwent LT can be complicated by immunohematologic problems. Blood banks should implement the DAT test in each transfusion to detect them.

Citing Articles

Safety assessment of RhD-positive red cell transfusion in RhD-negative liver-transplant recipients: Single-centre report from India.

Tiwari A, Arora D, Aggarwal G, Dara R, Bhardwaj G, Sharma J Indian J Med Res. 2021; 152(6):662-666.

PMID: 34145107 PMC: 8224149. DOI: 10.4103/ijmr.IJMR_315_19.

Transfusion Status in Liver and Kidney Transplantation Recipients-Results from Nationwide Claims Database.

Park B, Yoon J, Kim H, Jung Y, Lee K, Choi D J Clin Med. 2020; 9(11).

PMID: 33182639 PMC: 7697733. DOI: 10.3390/jcm9113613.

Quality Improvement in Transfusion Practice of Orthotopic Liver Transplantation Reduces Blood Utilization, Length of Hospital Stay, and Cost.

Nedelcu E, Wright M, Karp S, Cook M, Barbu O, Eichbaum Q Am J Clin Pathol. 2018; 151(4):395-402.

PMID: 30535323 PMC: 6593127. DOI: 10.1093/ajcp/aqy154.

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