The Association of Increased FFP:RBC Transfusion Ratio to Primary Graft Dysfunction in Bleeding Lung Transplantation Patients.
Journal Article (Journal Article)
OBJECTIVES: Lung transplantation is associated with a significant risk of needed transfusion. Although algorithm-based transfusion strategies that promote a high fresh frozen plasma:red blood cells (FFP:RBC) ratio have reduced overall blood product requirements in other populations, large-volume transfusions have been linked to primary graft dysfunction (PGD) in lung transplantation, particularly use of platelets and plasma. The authors hypothesized that in lung transplant recipients requiring large-volume transfusions, a higher FFP:RBC ratio would be associated with increased PGD severity at 72 hours. DESIGN: Observational retrospective review. SETTING: Single tertiary academic center. PARTICIPANTS: Adult patients undergoing bilateral or single orthotopic lung transplantation and receiving >4 U PRBC in the first 72 hours from February 2014 to March 2019. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patient demographics, operative characteristics, blood transfusions, and outcomes including PGD scores and length of stay were collected. Eighty-nine patients received >4U PRBC, had available 72-hour PGD data, and were included in the study. These patients were grouped into a high-ratio (>1:2 units of FFP:RBC, N = 38) or low-ratio group (<1:2 units of FFP:RBC, N = 51). Patients in the high-ratio group received more transfusions and factor concentrates and had significantly longer case length. The high-ratio group had a higher rate of severe PGD at 72 hours (60.5% v 23.5%, p = 0.0013) and longer hospital length of stay (40 v 32 days, p = 0.0273). CONCLUSIONS: In bleeding lung transplantation patients at high risk for PGD, a high FFP:RBC transfusion ratio was associated with worsened 72-hour PGD scores when compared with the low-ratio cohort.
Full Text
Duke Authors
- Bottiger, Brandi Anne
- Guinn, Nicole Renee
- Haney, John Carroll
- Hartwig, Matthew
- Klapper, Jacob A
- Poisson, Jessica Lynne
Cited Authors
- Seay, T; Guinn, N; Maisonave, Y; Fuller, M; Poisson, J; Pollak, A; Bryner, B; Haney, J; Klapper, J; Hartwig, M; Bottiger, B
Published Date
- November 2020
Published In
Volume / Issue
- 34 / 11
Start / End Page
- 3024 - 3032
PubMed ID
- 32622711
Electronic International Standard Serial Number (EISSN)
- 1532-8422
Digital Object Identifier (DOI)
- 10.1053/j.jvca.2020.05.043
Language
- eng
Conference Location
- United States