Alloimmunization to red blood cell antigens affects clinical outcomes in liver transplant patients.
Transfusion therapy of liver transplant patients remains a challenge. High volumes of intraoperative blood transfusion have been shown to increase the risk of poor graft or patient survival. We conducted a retrospective study of 209 consecutive liver transplant cases at our institution. Only patients receiving their first liver transplant, with no other simultaneous organ transplants, were included. Cox proportional hazard modeling was used to identify clinical variables correlated with postoperative patient mortality. Statistically significant variables for poor patient survival were the number of red blood cell and plasma units transfused, a history of red blood cell alloantibodies, and the immunosuppressive regimen used. History of pregnancy also approached statistical significance but was less robust than the other 3 variables. Our findings suggest that blood transfusion and immune modulation greatly affect the survival of patients after liver transplantation.
Department of Pathology, Stanford University, and Department of Transfusion Medicine, Stanford University Hospitals and Clinics, CA 94305, USA.
Scott D
SD
Boyd
Fabien
F
Stenard
Donald K K
DK
Lee
Lawrence T
LT
Goodnough
Carlos O
CO
Esquivel
Magali J
MJ
Fontaine
D000017:ABO Blood-Group System / Q000276:immunology*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004906:Erythrocyte Count; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007518:Isoantibodies / Q000097:blood*; D053208:Kaplan-Meier Estimate; D017093:Liver Failure / Q000097:blood / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D065227:Transfusion Reaction; D016896:Treatment Outcome
D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents; D007518:Isoantibodies