Transfusion has no effect on recurrence in hepatitis C after liver transplantation.
BACKGROUND
The literature suggests that blood product transfusions have a negative impact on the survival of liver transplant patients. We investigated the impact of intraoperative blood product usage on the survival of liver transplantation patients being transplanted for hepatitis C-related end-stage liver disease. In addition, we analyzed a potentially more sensitive metric, namely disease recurrence and fibrosis progression, obtained from follow-up liver biopsies.


METHODS
We retrospectively studied 194 consecutive patients with hepatitis C virus (HCV) undergoing liver transplantation. To investigate the effect of red blood cell (RBC) or platelet transfusions on post-transplant HCV recurrence, hepatic biopsy data from 4 months and 1 year after transplantation were studied. In addition, survival data were analyzed.


RESULTS
There was no effect of intraoperative RBC or platelet transfusion on either 1- or 5-year patient survival following liver transplantation. There was no difference in HCV disease recurrence or progression of hepatic fibrosis at 4 months or 1 year attributable either to RBC or to platelet transfusion.


CONCLUSIONS
This study was not able to confirm an effect on the survival of HCV-infected liver transplant patients related to intraoperative transfusion of RBCs or platelets. In addition, these transfusions had no effect on HCV recurrence or fibrosis progression. This is not to condone a liberal transfusion practice, but rather to reassure that when clinically indicated, transfusion does not have a significant impact on patient survival or disease recurrence in HCV-infected liver transplant patients.
Department of Anesthesiology, University of Florida College of Medicine, Gainesville, USA. mrice@anest.ufl.edu
M J
MJ
Rice
A
A
Wendling
R J
RJ
Firpi
A W
AW
Hemming
D R
DR
Nelson
W K
WK
Schwab
N
N
Gravenstein
T E
TE
Morey
D000328:Adult; D000368:Aged; D000758:Anesthesia; D015331:Cohort Studies; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D005260:Female; D006526:Hepatitis C / Q000473:pathology* / Q000601:surgery* / Q000821:virology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000473:pathology; D008113:Liver Neoplasms / Q000150:complications; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000235:genetics; D012008:Recurrence; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012306:Risk; D065227:Transfusion Reaction; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D012367:RNA, Viral