Transfusion-associated circulatory overload in gastroenterology

Area of Science:

• Gastroenterology
• Critical Care Medicine
• Transfusion Medicine

Background:

• Transfusion-associated circulatory overload (TACO) is a rare but serious complication of blood transfusions.
• Identifying TACO in patients with gastrointestinal (GI) bleeding is crucial due to high transfusion rates in this population.

Purpose of the Study:

• To determine the incidence of TACO in a cohort of highly transfused patients with GI bleeding.
• To identify risk factors associated with TACO development in this patient group.

Main Methods:

• A retrospective analysis of patients undergoing oesophago-gastro-duodenoscopy (OGD) was conducted over one year.
• Data on blood component transfusions and TACO development were collected and analyzed.

Main Results:

• A cumulative TACO incidence of 12.3% was observed in 81 transfused patients out of 278.
• Risk factors for TACO included age ≥80 years, renal disease, and cardiac disease.
• Patients with advanced liver cirrhosis (Child Pugh c10+) were most susceptible.
• TACO was associated with significantly lower overall survival rates at 3 years.

Conclusions:

• TACO may be significantly under-reported in the context of GI bleeding.
• Increased clinical vigilance for TACO is necessary in elderly GI patients, particularly those with cardiac or renal comorbidities.