title: Survival rate changes with transfusion of blood products during liver transplantation.
abstract: 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.
authors.affiliation: Hôpital St-Luc - CHUM, 1058, St-Denis, Montréal, Québec H2X 3J4, Canada. lmassicotte@hotmail.com
authors.forename: Luc
authors.initials: L
authors.lastname: Massicotte
authors.forename: Marie-Pascale
authors.initials: MP
authors.lastname: Sassine
authors.forename: Serge
authors.initials: S
authors.lastname: Lenis
authors.forename: Robert F
authors.initials: RF
authors.lastname: Seal
authors.forename: André
authors.initials: A
authors.lastname: Roy
mesh_terms: 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