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

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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.


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

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