Transfusion Management and Immunohematologic Complications in Liver Transplantation: Experience of a Single Institution

Data de publicació: 01/01/2015

Autors de IIS La Fe

Pilar Solves Alcaina

Autor
Nelly Carpio Martinez

Autor
Federico Moscardo Garcia

Autor
Alma Lancharro

Autor
Isabel Cano Ferri

Autor
Angel Moya Herraiz

Autor
Rafael López Andújar

Autor
Miguel Ángel Sanz Alonso

Autor

Grups d'Investigació

Hematología y Hemoterapia

Investigador Principal

Javier De La Rubia Comos
Hepatología experimental y Trasplante hepático

Investigador Principal

Laia Tolosa Pardo

Abstract

Objective: Liver transplantation (LT) has traditionally been associated with major blood loss and consequently high blood transfusion requirements. Our objective was to analyze transfusion management and incidence of immunohematologic complications in patients undergoing LT at our institution. Methods: A retrospective analysis of immunohematologic events and transfusion outcomes was carried out at La Fe University Hospital in Valencia. Data from 654 patients were reviewed: 654 underwent only one LT while 36 underwent second LT. Results: Patients received a median of 3 red blood cell (RBC) concentrates, 2 platelets concentrates (PCs) and 2 fresh frozen plasma units (FFPs). Variables significantly influencing RBC transfusions were: the MELD score, hemoglobin levels, and the platelet counts before LT. 27 patients (4.1%) had a positive antibody screening before transplant. Immunohematologic events occurred in 8% of the patients, mostly in the first month after LT, and involved hemolysis in 13 cases. Mortality was significantly higher in patients developing immunohematologic disorders (42.8 vs. 18.3%; p < 0.001). In the multivariable analysis, only ABO minor incompatibility between donor and recipient significantly increased the appearance of immunohematologic incidences (OR 4.92, 95% Cl 2.31-10.50; p < 0.001). Conclusion: Transfusion management of patients that underwent LT can be complicated by immunohematologic problems. Blood banks should implement the DAT test in each transfusion to detect them.

Dades de la publicació

ISSN/ISSNe:: 1660-3796, 1660-3818
Tipus:: Article
Pàgines:: 8-14
DOI:: 10.1159/000370260
PubMed:: 25960710
Factor d'Impacte:: 0,750 SCImago ℠
Quartil:: Q2 SCImago ℠

Documents

No hi ha documents

Mètriques

Filiacions

Solves P:: Blood Bank, Hematology Department, Hospital Universitari I Politècnic La Fe. Valencia, Spain
Carpio N:: Blood Bank, Hematology Department, Hospital Universitari I Politècnic La Fe. Valencia, Spain
Moscardo F:: Blood Bank, Hematology Department, Hospital Universitari I Politècnic La Fe. Valencia, Spain
Lancharro A:: Blood Bank, Hematology Department, Hospital Universitari I Politècnic La Fe. Valencia, Spain
Cano I:: Blood Bank, Hematology Department, Hospital Universitari I Politècnic La Fe. Valencia, Spain
Moya A:: Liver Transplant Unit, Hospital Universitari I Politècnic La Fe, Valencia, Spain
López-Andujar R:: Liver Transplant Unit, Hospital Universitari I Politècnic La Fe, Valencia, Spain
Sanz MÁ:: Blood Bank, Hematology Department, Hospital Universitari I Politècnic La Fe. Valencia, Spain

Keywords

Liver transplantation; Blood transfusion; Hemolysis; Immunohematologic event; Transfusion alloimmunization

Campos d'Estudi

Projectes associats

RED DE INVESTIGACION COOPERATIVA DE CANCER

RD06/0020/0031 . INSTITUTO DE SALUD CARLOS III; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2006

PROYECTO CAIBER

CAI08/01/0061 . INSTITUTO DE SALUD CARLOS III; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2009

CREACION Y MEJORA DE INFRAESTRUCTURAS EN MEDICINA REGENERATIVA

Investigador Principal: FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA

PLE2009-0141 ACI-PLAN E . MINISTERIO DE CIENCIA E INNOVACION; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2009