A multicenter study of blood component transfusion in patients with liver cirrhosis in China: Patient characteristics, transfusion practice, and outcomes.
BACKGROUND
Cirrhosis is a complex acquired disorder of hemostasis and patients frequently receive blood transfusions. But there is very limited data on patterns of blood use at a patient level.


OBJECTIVE
To characterize blood use in cirrhotic patients in China and compare with recommendations to help identify areas where quality improvement strategies can be targeted. We also compared findings to a similar study undertaken in UK.


METHODS
A cross-sectional study was conducted in 11 hospitals over a 2-month period. Data were collected prospectively on each hospitalized cirrhotic patient to day 28.


RESULTS
1595 cirrhotic patients were included and 20.6% were transfused. 48.2% of transfused patients received transfusion for bleeding, most commonly gastrointestinal bleeding (65.8%). The remaining 51.8% were transfused for non-bleeding indications. 32.5% of patients transfused for gastrointestinal bleeding with red blood cells had a pre-transfusion haemoglobin >7g/dL. 89.1% of patients transfused frozen plasma for non-bleeding indications received them in the absence of a planned procedure. The patterns of blood transfusion in cirrhosis were different between China and UK. Of note, empirical prophylactic use of frozen plasma was more common in the Chinese study (89%) than in the UK (24%).


CONCLUSIONS
Education and research should be implemented to improve patient blood management, especially in prophylactic frozen plasma use area.
Department of Blood Transfusion, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, PR China.
Guixiang
G
Sun
Department of Blood Transfusion, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, PR China.
Xiangfu
X
Liu
Department of Blood Transfusion, 302 Hospital of PLA, Beijing, PR China.
Zhiguo
Z
Liu
Department of Blood Transfusion, Chongqing Three Gorges Central Hospital, Chongqing, PR China.
Jianguo
J
Tan
Department of Blood Transfusion, The First Hospital of China Medical University, Shenyang, Liaoning Province, PR China.
Yiwen
Y
Hao
Department of Blood Transfusion, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong Province, PR China.
Guiqiu
G
Shan
Department of Blood Transfusion, 307 Hospital of PLA, Beijing, PR China.
Qun
Q
Luo
Department of Blood Transfusion, Chinese PLA General Hospital, Beijing, PR China.
Deqing
D
Wang
Department of Blood Transfusion, Urumqi General Hospital of PLA, Urumqi Xinjiang, PR China.
Yanchao
Y
Xing
Department of Blood Transfusion, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shanxi Province, PR China.
Xianqing
X
Zhang
Department of Blood Transfusion, Beijing Hospital, Beijing, PR China.
Jiwu
J
Gong
Department of Blood Transfusion, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, PR China.
Lihua
L
Kuang
NHS Blood and Transplant/Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, United Kingdom.
Simon J
SJ
Stanworth
Department of Blood Transfusion, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, PR China. Electronic address: dpyysxkwaq@hotmail.com.
Aiqing
A
Wen
D000328:Adult; D000368:Aged; D016913:Blood Component Transfusion / Q000706:statistics & numerical data*; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010949:Plasma; D011446:Prospective Studies; D058996:Quality Improvement; D006113:United Kingdom
D006454:Hemoglobins
Blood transfusion; Cirrhosis; Frozen plasma; Patient blood management