title: Retrospective analysis of perioperative transfusion requirements in living donor renal transplantation.
abstract: BACKGROUND
  Extensive bleeding in solid organ transplantation is a major challenge faced by transplant surgeons. Our aim was to audit the peri-operative transfusion requirements in our patients.
  
  
  METHODS
  A retrospective analysis of living donor renal transplant surgeries performed from 1st May 2014 to 31st December 2014 was done. The blood/blood component usage during the peri-operative period was obtained. Univariate analysis was performed and the significant factors identified were further analyzed through multivariate regression analysis.
  
  
  RESULTS
  A total of 510 patients (398 males: 78%, and 112 females: 22%) ranging from 18 to 77 years in age were included in the study. Of these, 269 (52.7%) patients were not transfused, while 241 (47.3%) patients received a total of 845 units of blood/blood components. The mean pre-operative hemoglobin in the transfused group was 8.7g/dl while in the non-transfused group it was 10.3g/dl. Leukoreduced packed red blood cell (PRBC) was the major blood component transfused during the peri-operative period. Multivariate regression analysis revealed that pre-operative hemoglobin was a major predictor of intra-operative PRBC transfusion (p = <0.001). Average post-operative length of stay (PLOS) was 10 ± 6 days. There was no significant difference in the PLOS between the transfused and non-transfused groups of patients; however, a statistical significant increase in utilization for both PRBC (p = 0.044) and fresh frozen plasma (p = 0.002) was observed with increased PLOS.
  
  
  CONCLUSIONS
  Nearly 47.3% of patients undergoing living donor renal transplant received transfusion. PRBC was the most common product transfused and pre-operative hemoglobin was identified as strong predictor of blood consumption.
authors.affiliation: Department of Transfusion Medicine, Indraprastha Apollo Hospital, Delhi 110076, India.
authors.forename: Raj Nath
authors.initials: RN
authors.lastname: Makroo
authors.affiliation: Department of Transfusion Medicine, Indraprastha Apollo Hospital, Delhi 110076, India. Electronic address: docbrindakakkar@gmail.com.
authors.forename: Brinda
authors.initials: B
authors.lastname: Kakkar
authors.affiliation: Department of Transfusion Medicine, Indraprastha Apollo Hospital, Delhi 110076, India.
authors.forename: Mohit
authors.initials: M
authors.lastname: Chowdhry
authors.affiliation: Department of Transfusion Medicine, Indraprastha Apollo Hospital, Delhi 110076, India.
authors.forename: Sweta
authors.initials: S
authors.lastname: Nayak
authors.affiliation: Department of Transfusion Medicine, Indraprastha Apollo Hospital, Delhi 110076, India.
authors.forename: Aakanksha
authors.initials: A
authors.lastname: Bhatia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D007902:Length of Stay; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Anemia; Blood transfusion; Chronic kidney disease; Erythropoietin; Renal transplant