在肝移植期间进行超大规模输血
Warangkana Lapisatepun1,2, Christina Ma1, Worakitti Lapisatepun3
1Departments of Anesthesiology, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
肝移植 (LT) 期间超大规模输血 (SMT) 影响5.6%的患者. 识别SMT的风险因素和生存预测因素对于管理这些具有挑战性的病例至关重要.
科学领域:
- 肝胆道手术是肝胆道的手术.
- 输血药物 输血药物 输血药物
- 移植免疫学 移植免疫学
背景情况:
- 肝移植 (LT) 期间的大规模出血和输血带来了重大的临床挑战.
- 超大规模输血 (SMT),定义为输血≥50单位红细胞 (RBC),需要仔细调查.
- 了解SMT发生率,风险因素和生存结果对于患者管理至关重要.
研究的目的:
- 调查LT期间SMT的发病率和独立风险因素.
- 分析接受SMT的患者的生存结果.
- 为了确定影响SMT患者的生存时间的负面因素,接受LT.
主要方法:
- 在2004年至2019年期间接受LT的成年患者的回顾性分析.
- 在LT期间,SMT定义为≥50个单位的红细胞输血.
- 多变量逻辑回归用于风险因素识别和Cox生存分析,用于生存预测因素.
主要成果:
- 在LT患者中,SMT发生在5.6% (158/2772) 的患者中,平均输血量为72.6 (±23.4) RBC单位.
- 独立的SMT风险因素包括MELD-Na得分,之前的腹部上部手术,门静脉血栓症和远程再移植.
- 在SMT患者中,90天生存率为81.6%;手术前的肺高血压和大量的再生输血后输血是负生存预测因素.
结论:
- SMT是LT的罕见并发症,发生在很少的患者中.
- 尽管它很罕见,但SMT与相对令人满意的短期生存有关.
- 识别手术前的风险因素和负生存预测因素可以提高对接受LT的SMT患者的理解和管理.
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