Association of intraoperative transfusion of blood products with mortality in lung transplant recipients.
BACKGROUND
The impact of intraoperative transfusion on postoperative mortality in lung transplant recipients is still elusive.


METHODS
Univariate and multivariate analysis were performed to investigate the influence of red blood cells (RBCs) and fresh frozen plasma (FFP) on mortality in 134 consecutive lung transplants recipients from September 2003 until December 2008.


RESULTS
Intraoperative transfusion of RBCs and FFP was associated with a significant increase in mortality with odds ratios (ORs) of 1.10 (1.03 to 1.16, P = 0.02) and 1.09 (1.02 to 1.15, P = 0.03), respectively. For more than four intraoperatively transfused RBCs multivariate analysis showed a hazard ratio for mortality of 3.8 (1.40 to 10.31, P = 0.003). Furthermore, non-survivors showed a significant increase in renal replacement therapy (RRT) (36.6% versus 6.9%, P <0.0001), primary graft dysfunction (PGD) (39.3% versus 5.9%, P <0.0001), postoperative need of extracorporeal membrane oxygenation (ECMO) (26.9% versus 3.1%, P = 0.0019), sepsis (24.2% versus 4.0%, P = 0.0004), multiple organ dysfunction syndrome (MODS) (26.9% versus 3.1%, P <0.0001), infections (18.1% versus 0.9%, P = 0.0004), retransplantation (12.1% versus 6.9%, P = 0.039) and readmission to the ICU (33.3% versus 12.8%, P = 0.024).


CONCLUSIONS
Intraoperative transfusion is associated with a strong negative influence on outcome in lung transplant recipients.
Surgical Intensive Care Medicine, University Hospital of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Denise
D
Weber
Surgical Intensive Care Medicine, University Hospital of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Silvia R
SR
Cottini
Surgical Intensive Care Medicine, University Hospital of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Pascal
P
Locher
Surgical Intensive Care Medicine, University Hospital of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Urs
U
Wenger
Surgical Intensive Care Medicine, University Hospital of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Paul A
PA
Stehberger
Surgical Intensive Care Medicine, University Hospital of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Mario
M
Fasshauer
Surgical Intensive Care Medicine, University Hospital of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Reto A
RA
Schuepbach
Surgical Intensive Care Medicine, University Hospital of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Markus
M
Béchir