Document Detail


Risk factors for bleeding and transfusion during orthotopic liver transplantation.
MedLine Citation:
PMID:  21353450     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: While orthotopic liver transplantation (OLT) can be associated with haemorrhage, the risk factors for bleeding and transfusion remain difficult to predict. Perioperative transfusion has potentially deleterious side effects and impairs graft and patient survival. Preoperative identification of patients at high risk of bleeding is of clinical interest to manage perioperative transfusion and blood product storage. STUDY DESIGN: Retrospective study. PATIENTS AND METHODS: All OLT conducted between 2004 and 2008 in the University Hospital of Bordeaux were studied. Risk factors for bleeding greater than one blood volume and for massive red blood cell (RBC) transfusion were determined using univariate and multivariate analysis. Thresholds were determined with ROC curve analysis. RESULTS: One hundred and forty-eight transplantations were studied. Preoperative haemoglobin and Child class A were independent protective risk factors for bleeding greater than one blood volume (OR 0.81 [0.67-0.98] and 0.27 [0.10-0.72], respectively). Preoperative Hb was a protective risk factor (OR 0.71 [0.58-0.88]) whereas history of oesophageal varicose bleeding was a risk factor (OR 4.67 [1.45-15.05]) for transfusion of more than eight RBC. CONCLUSION: Risk factors for bleeding and transfusion during OLT identified in this study were of little clinical usefulness so blood products should always be available during the procedure.
Authors:
S Roullet; M Biais; E Millas; P Revel; A Quinart; F Sztark
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-23
Journal Detail:
Title:  Annales francaises d'anesthesie et de reanimation     Volume:  -     ISSN:  1769-6623     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8213275     Medline TA:  Ann Fr Anesth Reanim     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Masson SAS. All rights reserved.
Affiliation:
Service d'anesthésie-réanimation 1, CHU de Bordeaux, université Victor-Segalen-Bordeaux 2, 33076 Bordeaux cedex, France.
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