title: Impact of Model for End-Stage Liver Disease score on transfusion rates in liver transplantation.
abstract: BACKGROUND
  Liver transplantation (OLT) can entail a high risk of blood loss requiring transfusions, which increase morbidity and mortality. In recent years many efforts have been spent to improve the surgical and anesthetic management to decrease transfusion rates during OLT. Preoperative predictors for transfusion in OLT, remain uncertain.
  
  
  METHODS
  We retrospectively reviewed the 219 OLT performed from 2005 to 2011 focusing on blood product (BP) transfusions. Statistical analysis sought the impact of transfusions on OLT outcomes to identify possible independent predictors of higher BP requirements.
  
  
  RESULTS
  The 1- and 3-year survival rates were 86.6% and 76.45% for patients and 81.0% and 71.8% for grafts respectively. The mean intra- and perioperative red blood cell (RBC) transfusion rates were 12.3 ± 11.7 U and 15.5 ± 13.0 U respectively. A statistical analysis demonstrated a significant influence of BP transfusion on post-OLT complications and survivals. Multivariate logistic regression analysis showed the Model for End-Stage Liver Disease (MELD) score to be the only independent predictor of perioperative RBC transfusions.
  
  
  CONCLUSIONS
  Our results confirmed the link between intra- and perioperative transfusions and outcome of OLT patients. MELD score resulted the only independent variable associated with increased perioperative RBC transfusions.
authors.affiliation: General Surgery and Organ Transplantation Unit, IRCCS San Martino University Hospital, IST National Institute for Cancer Research, San Martino, Italy. Electronic address: gvarotti@hotmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Varotti
authors.forename: G
authors.initials: G
authors.lastname: Santori
authors.forename: E
authors.initials: E
authors.lastname: Andorno
authors.forename: N
authors.initials: N
authors.lastname: Morelli
authors.forename: M
authors.initials: M
authors.lastname: Ertreo
authors.forename: P
authors.initials: P
authors.lastname: Strada
authors.forename: E
authors.initials: E
authors.lastname: Porcile
authors.forename: M
authors.initials: M
authors.lastname: Casaccia
authors.forename: M
authors.initials: M
authors.lastname: Centanaro
authors.forename: U
authors.initials: U
authors.lastname: Valente
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D012189:Retrospective Studies; D015996:Survival Rate