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Perioperative Fresh Red Blood Cell Transfusion May Negatively Affect Recipient Survival After Liver Transplantation.

Publication ,  Conference
Han, S; Kwon, JH; Jung, SH; Seo, JY; Jo, YJ; Jang, JS; Yeon, SM; Jung, SH; Ko, JS; Gwak, MS; Cho, D; Son, HJ; Kim, GS
Published in: Ann Surg
February 2018

OBJECTIVE: The aim of this study is to evaluate the association between fresh red blood cell (RBC) transfusion and recipient survival after liver transplantation. BACKGROUND: Fresh RBC products contain many viable leukocytes. Allogeneic leukocytes are responsible for adverse transfusion reactions in the immunocompromised host. METHODS: Among 343 liver transplant recipients who underwent perioperative RBC transfusion, 91 of 226 who did not receive fresh RBCs were matched with 91 of 117 who received fresh RBCs with 1:1 matching ratio using the propensity score based on the amount of transfused blood products and others. Survival analysis was performed using the Cox model. RESULTS: All transfused 3230 RBCs were leukoreduced and irradiated. Before matching, recipients in fresh RBC group received 3 U (2-6 U) of fresh RBCs. After a median follow-up of 60 months, 60 of 343 recipients (17.5%) died. Survival probability at 1/2/5 years after transplantation was 94.7%/92.0%/85.8% for nonfresh RBC group and 82.9%/76.0%/72.0% for fresh RBC group [death hazard ratio (HR) = 2.37 (1.43-3.94), P = 0.001]. In multivariable analysis, fresh RBC transfusion was significantly associated with increased death risk [HR = 2.33 (1.35-4.01), P = 0.002]. After matching, recipients in fresh RBC group received 3 U (2-5 U) of fresh RBCs. After a median follow-up of 56 months, 35 of 182 recipients (19.2%) died. Survival probability at 1/2/5 years was 95.6%/93.2%/86.0% for nonfresh RBC group and 85.7%/78.0%/73.0% for fresh RBC group [HR = 2.23 (1.43-3.94), P = 0.028]. Multivariable analysis confirmed a significance of fresh RBC transfusion [HR = 3.20 (1.51-6.78), P = 0.002]. CONCLUSION: Our findings suggest a potential negative impact of fresh RBC transfusion on the survival of patients undergoing liver transplantation.

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Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

February 2018

Volume

267

Issue

2

Start / End Page

346 / 351

Location

United States

Related Subject Headings

  • Transfusion Reaction
  • Surgery
  • Retrospective Studies
  • Proportional Hazards Models
  • Propensity Score
  • Perioperative Care
  • Middle Aged
  • Male
  • Living Donors
  • Liver Transplantation
 

Citation

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Chicago
ICMJE
MLA
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Han, S., Kwon, J. H., Jung, S. H., Seo, J. Y., Jo, Y. J., Jang, J. S., … Kim, G. S. (2018). Perioperative Fresh Red Blood Cell Transfusion May Negatively Affect Recipient Survival After Liver Transplantation. In Ann Surg (Vol. 267, pp. 346–351). United States. https://doi.org/10.1097/SLA.0000000000002062
Han, Sangbin, Ji Hye Kwon, Sun Hee Jung, Ji Young Seo, Yong Jun Jo, Jin Sung Jang, Seung Min Yeon, et al. “Perioperative Fresh Red Blood Cell Transfusion May Negatively Affect Recipient Survival After Liver Transplantation.” In Ann Surg, 267:346–51, 2018. https://doi.org/10.1097/SLA.0000000000002062.
Han S, Kwon JH, Jung SH, Seo JY, Jo YJ, Jang JS, et al. Perioperative Fresh Red Blood Cell Transfusion May Negatively Affect Recipient Survival After Liver Transplantation. In: Ann Surg. 2018. p. 346–51.
Han, Sangbin, et al. “Perioperative Fresh Red Blood Cell Transfusion May Negatively Affect Recipient Survival After Liver Transplantation.Ann Surg, vol. 267, no. 2, 2018, pp. 346–51. Pubmed, doi:10.1097/SLA.0000000000002062.
Han S, Kwon JH, Jung SH, Seo JY, Jo YJ, Jang JS, Yeon SM, Ko JS, Gwak MS, Cho D, Son HJ, Kim GS. Perioperative Fresh Red Blood Cell Transfusion May Negatively Affect Recipient Survival After Liver Transplantation. Ann Surg. 2018. p. 346–351.

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

February 2018

Volume

267

Issue

2

Start / End Page

346 / 351

Location

United States

Related Subject Headings

  • Transfusion Reaction
  • Surgery
  • Retrospective Studies
  • Proportional Hazards Models
  • Propensity Score
  • Perioperative Care
  • Middle Aged
  • Male
  • Living Donors
  • Liver Transplantation