Effect of intraoperative blood transfusion on patient outcome in hepatic transplantation.

Abstract

IMPROVEMENTS IN patient selection, surgical techniques, postoperative management, and immunosuppression for orthotopic liver transplantation (OLT) have led to patient survival approaching 80% at 1 year.¹ While attempts have been made to identify factors affecting patient and graft survival, no set of uniform predictive variables has been described.^2-5 The effect of intraoperative blood loss and transfusions on survival after liver transplantation has been assessed by several different centers, with most data showing a correlation between blood use and postoperative morbidity and mortality rates.^2,3,6-8 During a 3-year period, a substantial proportion of our adult patients underwent OLT without intraoperative transfusion of red blood cells (RBCs). These patients were compared with recipients who received at least 1 U of RBCs intraoperatively to determine the effect of not giving patients RBC transfusions on patient and graft survival rates after OLT.