P-217 Laboratory predictors of massive transfusion in liver transplantation: Single-center experience

Document Type

Article

Department

Anaesthesia

Abstract

Purpose: We evaluated whether routinely performed laboratory tests can predict massive transfusion defined as transfusion of 10 or more units of packed Red Blood Cells (pRBCs) during liver transplantation.
Methods: We extracted laboratory values and blood utilization data from the electronic hospital databases, on all adult deceased donor liver transplant recipients during 04/10-12/13 period. Regression analyses were performed to identify predictors of massive transfusion.
Results: We identified 167 recipients; 28.7% received massive transfusion. Preoperative laboratory values are summarized below Table.1
Recipients received median of 5 (interquartile range (IQR) 2-12) units of pRBCs, median of 6 (IQR 2-12) units of Fresh Frozen Plasma; 59.3% received platelets, and 40.7% received cryoprecipitate; 16.8% received salvaged blood. In a univariate logistic regression the following laboratory tests predicted massive transfusion: hemoglobin (OR 0.65 for each 1 g/dL increase in hemoglobin; 95% CI 0.51-0.81), platelets (OR 0.91 for each 10,000/ml increase in platelet count; 95% CI 0.84-0.98), and Thromboelastography R-time (OR 1.25 for each 1 second increase in R-time; 95% CI 1.04-1.50). In multivariable logistic regression hemoglobin (OR 0.61, 95% CI 0.46- 0.80), platelets (OR 0.89, 95% CI 0.81-0.99), R-time (OR 1.37, 95% CI 1.08-1.78) and K-time (OR 0.66, 95% CI 0.46-0.97) were significant, with final model AUC=0.79.
Conclusions: Preoperative hemoglobin, platelets level, R-time and K-time are predictors of massive blood transfusion, however, they do not account for entire variability in data.

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

Transplantation

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