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Blood Transfusion and Agglutination02:45

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Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
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Super-massive transfusion during liver transplantation.

Warangkana Lapisatepun1,2, Christina Ma1, Worakitti Lapisatepun3

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|July 26, 2023
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Summary

Super-massive transfusion (SMT) during liver transplantation (LT) affects 5.6% of patients. Identifying risk factors and survival predictors for SMT is crucial for managing these challenging cases.

Keywords:
liver transplantationoutcomesrisk factorssuper-massive blood transfusion

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Area of Science:

  • Hepatobiliary surgery
  • Transfusion medicine
  • Transplant immunology

Background:

  • Massive hemorrhage and transfusion during liver transplantation (LT) pose significant clinical challenges.
  • Super-massive transfusion (SMT), defined as transfusion of ≥50 units of red blood cells (RBC), requires careful investigation.
  • Understanding SMT incidence, risk factors, and survival outcomes is critical for patient management.

Purpose of the Study:

  • To investigate the incidence and independent risk factors for SMT during LT.
  • To analyze survival outcomes in patients who received SMT.
  • To identify factors negatively affecting survival in SMT patients undergoing LT.

Main Methods:

  • Retrospective analysis of adult patients undergoing LT between 2004 and 2019.
  • SMT defined as ≥50 units of RBC transfusion during LT.
  • Multivariable logistic regression for risk factor identification and Cox survival analysis for survival predictors.

Main Results:

  • SMT occurred in 5.6% (158/2772) of LT patients, with a mean transfusion of 72.6 (±23.4) RBC units.
  • Independent risk factors for SMT included MELD-Na score, previous upper abdominal surgery, portal vein thrombosis, and remote retransplant.
  • Ninety-day survival rate in SMT patients was 81.6%; preoperative pulmonary hypertension and massive postreperfusion transfusion were negative survival predictors.

Conclusions:

  • SMT is a rare complication of LT, occurring in a small patient percentage.
  • Despite its rarity, SMT is associated with relatively satisfactory short-term survival.
  • Identifying preoperative risk factors and negative survival predictors enhances understanding and management of SMT patients undergoing LT.