Survival rate changes with transfusion of blood products during liver transplantation.
OBJECTIVE
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).


CONCLUSIONS
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.
Massicotte
Luc
L
Hôpital St-Luc - CHUM, 1058, St-Denis, Montréal, Québec H2X 3J4, Canada. lmassicotte@hotmail.com
Sassine
Marie-Pascale
MP
Lenis
Serge
S
Seal
Robert F
RF
Roy
André
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D004906:Erythrocyte Count; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D016031:Liver Transplantation / Q000401:mortality*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate