The perioperative use of blood components during heart and heart-lung transplantation.
Perioperative blood usage during 172 heart transplants (HTs) and 100 heart-lung transplants (HTLs) performed at the same center during 1986 and 1989 was reviewed. In 1986, 79 HTs were performed with a median (interquartile range) blood component use of 12 (range, 8-20) units, of which 6 (range, 4-8) constituted red cell components. The use of blood components was significantly reduced (p less than 0.05 by the Mann-Whitney U test) in 1989 to 10 (range, 8-20) units, of which red cell components constituted 5 (range, 3-7) units. Fifty HLTs in 1986 used a median (interquartile range) of 25.5 (range, 11.5-53) units of blood components. This use was significantly reduced (p less than 0.05) to a median of 18 (range, 9-29) units in 1989, of which 8 (range, 5-11) were red cell components, 4 (range, 2-8) were units of fresh-frozen plasma, and 5 (range, 0-10) were units of platelets. More blood components were used in patients who had previous cardiothoracic surgery and/or previous transplants; this reached significance in the 1986 HTs (p less than 0.001). Fresh blood was used in only one HT but in 12 (24%) of 1086 HLTs and 4 (8%) of 1989 HLTs. As the indication for fresh blood was excessive bleeding, there was a significantly greater use of blood components in 1989 HLT patients receiving fresh blood than in those not receiving fresh blood (median [range] of 163.5 [62-251] units compared to 15.5 [3-126]).(ABSTRACT TRUNCATED AT 250 WORDS)
Hunt
B J
BJ
Harefield Hospital, Middlesex, UK.
Sack
D
D
Amin
S
S
Yacoub
M H
MH
D000328:Adult; D016913:Blood Component Transfusion / Q000706:statistics & numerical data*; D002648:Child; D016027:Heart Transplantation / Q000401:mortality; D016041:Heart-Lung Transplantation / Q000401:mortality; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D008485:Medical Audit; D015996:Survival Rate