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Intraoperative Red Blood Cell Transfusion and Primary Graft Dysfunction After Lung Transplantation.

Publication ,  Conference
Subramaniam, K; Loor, G; Chan, EG; Bottiger, BA; Ius, F; Hartwig, MG; Daoud, D; Zhang, Q; Wei, Q; Villavicencio-Theoduloz, MA; Osho, AA ...
Published in: Transplantation
July 1, 2023

BACKGROUND: In this international, multicenter study of patients undergoing lung transplantation (LT), we explored the association between the amount of intraoperative packed red blood cell (PRBC) transfusion and occurrence of primary graft dysfunction (PGD) and associated outcomes. METHODS: The Extracorporeal Life Support in LT Registry includes data on LT recipients from 9 high-volume (>40 transplants/y) transplant centers (2 from Europe, 7 from the United States). Adult patients who underwent bilateral orthotopic lung transplant from January 2016 to January 2020 were included. The primary outcome of interest was the occurrence of grade 3 PGD in the first 72 h after LT. RESULTS: We included 729 patients who underwent bilateral orthotopic lung transplant between January 2016 and November 2020. LT recipient population tertiles based on the amount of intraoperative PRBC transfusion (0, 1-4, and >4 units) were significantly different in terms of diagnosis, age, gender, body mass index, mean pulmonary artery pressure, lung allocation score, hemoglobin, prior chest surgery, preoperative hospitalization, and extracorporeal membrane oxygenation requirement. Inverse probability treatment weighting logistic regression showed that intraoperative PRBC transfusion of >4 units was significantly ( P  < 0.001) associated with grade 3 PGD within 72 h (odds ratio [95% confidence interval], 2.2 [1.6-3.1]). Inverse probability treatment weighting analysis excluding patients with extracorporeal membrane oxygenation support produced similar findings (odds ratio [95% confidence interval], 2.4 [1.7-3.4], P  < 0.001). CONCLUSIONS: In this multicenter, international registry study of LT patients, intraoperative transfusion of >4 units of PRBCs was associated with an increased risk of grade 3 PGD within 72 h. Efforts to improve post-LT outcomes should include perioperative blood conservation measures.

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Published In

Transplantation

DOI

EISSN

1534-6080

Publication Date

July 1, 2023

Volume

107

Issue

7

Start / End Page

1573 / 1579

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Primary Graft Dysfunction
  • Lung Transplantation
  • Lung
  • Humans
  • Erythrocyte Transfusion
  • Adult
  • 3204 Immunology
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
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Subramaniam, K., Loor, G., Chan, E. G., Bottiger, B. A., Ius, F., Hartwig, M. G., … Sanchez, P. G. (2023). Intraoperative Red Blood Cell Transfusion and Primary Graft Dysfunction After Lung Transplantation. In Transplantation (Vol. 107, pp. 1573–1579). United States. https://doi.org/10.1097/TP.0000000000004545
Subramaniam, Kathirvel, Gabriel Loor, Ernest G. Chan, Brandi A. Bottiger, Fabio Ius, Matthew G. Hartwig, Daoud Daoud, et al. “Intraoperative Red Blood Cell Transfusion and Primary Graft Dysfunction After Lung Transplantation.” In Transplantation, 107:1573–79, 2023. https://doi.org/10.1097/TP.0000000000004545.
Subramaniam K, Loor G, Chan EG, Bottiger BA, Ius F, Hartwig MG, et al. Intraoperative Red Blood Cell Transfusion and Primary Graft Dysfunction After Lung Transplantation. In: Transplantation. 2023. p. 1573–9.
Subramaniam, Kathirvel, et al. “Intraoperative Red Blood Cell Transfusion and Primary Graft Dysfunction After Lung Transplantation.Transplantation, vol. 107, no. 7, 2023, pp. 1573–79. Pubmed, doi:10.1097/TP.0000000000004545.
Subramaniam K, Loor G, Chan EG, Bottiger BA, Ius F, Hartwig MG, Daoud D, Zhang Q, Wei Q, Villavicencio-Theoduloz MA, Osho AA, Chandrashekaran S, Noguchi Machuca T, Van Raemdonck D, Neyrinck A, Toyoda Y, Kashem MA, Huddleston S, Ryssel NR, Sanchez PG. Intraoperative Red Blood Cell Transfusion and Primary Graft Dysfunction After Lung Transplantation. Transplantation. 2023. p. 1573–1579.

Published In

Transplantation

DOI

EISSN

1534-6080

Publication Date

July 1, 2023

Volume

107

Issue

7

Start / End Page

1573 / 1579

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Primary Graft Dysfunction
  • Lung Transplantation
  • Lung
  • Humans
  • Erythrocyte Transfusion
  • Adult
  • 3204 Immunology
  • 3202 Clinical sciences