This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply View responses Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Massicotte, L. Articles by Roy, A. Search for Related Content PubMed PubMed Citation Articles by Massicotte, L. Articles by Roy, A.

Survival rate changes with transfusion of blood products during liver transplantation

[Le taux de survie change avec la transfusion de produits sanguins pendant la transplantation hépatique]

Luc Massicotte, MD^*, Marie-Pascale Sassine, PhD^*, Serge Lenis, MD FRCPC^*, Robert F. Seal, MD FRCPC and André Roy, MD FRCSC

^* From the Departments of Anesthesiology and
Surgery (Hepatobiliary Service), Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, Québec; and
the Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada.

Address correspondence to: Dr. Luc Massicotte, Hôpital St-Luc – CHUM, 1058, St-Denis, Montréal, Québec H2X 3J4, Canada. Phone: 514-890-8000, ext. 36581; Fax: 514-412-7310; E-mail: lmassicotte{at}hotmail.com

Purpose: To determine whether red blood cell (RBC) or plasma transfusion is associated with the one-year survival rate variation previously detected in liver transplantation.

Methods: A retrospective study of 206 consecutive liver transplantations was undertaken. Intraoperative transfusions of blood products were identified. Twenty-seven variables were studied using univariate and multivariate analyses to identify factors that were associated significantly with survival rate. For analysis of one-year survival, the cases were studied according to the transfused blood products. Patients were stratified according to the degree of RBC and plasma transfusion into four groups: more than four units of RBC, one to four units of RBC, plasma transfusion only, and no plasma or RBC transfusions.

Results: Patients received an average of 2.8 ± 3.5 units of RBC and 4.1 ± 4.1 units of plasma. Thirty-two percent of the patients did not receive any RBC transfusion and 19.4% did not receive any blood products. The one-year survival rate was 81.9% for all patients and 97.4% for patients without any transfusions. Of the 27 variables evaluated, only RBC and plasma transfusions were associated with significant decrease in the one-year survival rate, which was seen in the group who received only plasma (76.9%, P = 0.014) and the group who received more than four units of RBC (62.5%, P < 0.0001).

Conclusion: Although we cannot demonstrate causality, our analysis shows that our one-year survival rate following liver transplantation decreased significantly with the intraoperative transfusion of any amount of plasma or more than four units of RBC.

This article has been cited by other articles:

				M. T. de Boer, M. C. Christensen, M. Asmussen, C. S. van der Hilst, H. G. D. Hendriks, M. J. H. Slooff, and R. J. Porte The Impact of Intraoperative Transfusion of Platelets and Red Blood Cells on Survival After Liver Transplantation Anesth. Analg., January 1, 2008; 106(1): 32 - 44. [Abstract] [Full Text] [PDF]

				D. Fabbroni and M. Bellamy Anaesthesia for hepatic transplantation CEACCP, October 1, 2006; 6(5): 171 - 175. [Full Text] [PDF]

				L. Massicotte, S. Lenis, L. Thibeault, M.-P. Sassine, R. F. Seal, and A. Roy Reduction of blood product transfusions during liver transplantation Can J Anesth, May 1, 2005; 52(5): 545 - 546. [Full Text] [PDF]

eLetters: