title: Changes in transfusion practice over time in adult patients undergoing liver transplantation.
abstract: OBJECTIVE
  The aim of this study was to investigate changes in transfusion practice over time in liver transplantation surgery and to evaluate potential causes for changes in practice and report associated perioperative morbidity and mortality.
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  A single tertiary referral academic hospital.
  
  
  METHODS
  Two cohorts of 100 sequential adult primary liver transplant recipients: Early practice (1990-1991) and recent practice (2005-2006).
  
  
  METHODS
  None.
  
  
  RESULTS
  Perioperative transfusion and hemoglobin data were recorded. Mortality and postoperative complications were identified up to 30 days postoperatively. Appropriate intergroup statistical comparisons were made; p ≤ 0.05 was considered statistically significant. Compared with the early group, the recent group had significantly fewer perioperative allogeneic red blood cell transfusions, intraoperative autotransfusions, and transfusions of other blood products. No change in perioperative transfusion triggers was identified. There were no significant alterations in perioperative morbidity or mortality.
  
  
  CONCLUSIONS
  When compared with patients in the early group, recent cohort patients received significantly fewer blood transfusions. The authors attribute this observation to changes in surgical technique rather than a significant alteration in transfusion triggers over the studied time period.
authors: Department of Anesthesiology and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA. findlay.james@mayo.edu
authors: James Y
authors: JY
authors: Findlay
authors: Timothy R
authors: TR
authors: Long
authors: Michael J
authors: MJ
authors: Joyner
authors: Julie K
authors: JK
authors: Heimbach
authors: C Thomas
authors: CT
authors: Wass
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000379:methods* / Q000639:trends*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods / Q000639:trends*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome