title: Preoperative factors as predictors of blood product transfusion requirements in orthotopic liver transplantation.
abstract: BACKGROUND
  Intraoperative transfusion can affect the chance of graft survival in liver transplantation, a complicated operation with massive blood loss. Verification of factors that are predictive of intraoperative blood loss and transfusion increases the quality of anesthesia management.
  
  
  OBJECTIVE
  To assess use of blood and blood products between 2002 and 2008 and to evaluate factors associated with blood loss and requirement for blood products in adult patients undergoing orthotopic liver transplantation via piggyback technique.
  
  
  METHODS
  Medical charts and anesthesia records from 261 eligible adult recipients of an orthotopic liver transplant between March 2002 and May 2008 were reviewed.
  
  
  METHODS
  Shiraz Liver Transplantation Center, the only active liver transplantation center in Iran.
  
  
  METHODS
  Potential influencing factors in blood loss and transfusion, including sex, preoperative hemoglobin level, international normalized ratio, primary diagnosis, platelet count, creatinine level, Model for End-Stage Liver Disease (MELD) score, central venous pressure, and total anesthesia time, were measured and subjected to multivariable analysis.
  
  
  RESULTS
  Mean blood loss was 54.2 (SD, 47.9) mL/kg, the mean (SD) for amounts of blood products transfused was 25.3 (19.5) mL/kg for packed red blood cells, 2.6 (3.3) units for fresh frozen plasma, and 1.7 (3.1) units for platelets. Seven recipients (2.7%) underwent transplantation without intraoperative transfusion of red blood cells, whereas 25 patients (9.6%) received more than 10 units of red blood cells intraoperatively. Multivariable analysis showed that no preoperative factor was a predictor of blood loss or requirement for intraoperative transfusion. Transfusion of fresh frozen plasma and packed red blood cells was significantly lower in 2005, 2006, 2007, and 2008 than in 2003 to 2004 (P < .001).
authors: Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Sina
authors: S
authors: Ghaffaripour
authors: Hilda
authors: H
authors: Mahmoudi
authors: Mohammad B
authors: MB
authors: Khosravi
authors: Mohammad Ali
authors: MA
authors: Sahmeddini
authors: Hossein
authors: H
authors: Eghbal
authors: Hossein
authors: H
authors: Sattari
authors: Kourosh
authors: K
authors: Kazemi
authors: Seyed Ali
authors: SA
authors: Malekhosseini
mesh_terms: D000328:Adult; D000465:Algorithms; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D016031:Liver Transplantation; D008297:Male; D015999:Multivariate Analysis; D010347:Patient Care Planning; D011300:Preoperative Care; D012189:Retrospective Studies; D018570:Risk Assessment