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. 2013 Sep 27;2(1):20.
doi: 10.1186/2047-0525-2-20.

Association of intraoperative transfusion of blood products with mortality in lung transplant recipients

Denise Weber #  1 , Silvia R Cottini #  1 , Pascal Locher  1 , Urs Wenger  1 , Paul A Stehberger  1 , Mario Fasshauer  1 , Reto A Schuepbach  1 , Markus Béchir  1
Affiliations

Association of intraoperative transfusion of blood products with mortality in lung transplant recipients

Denise Weber et al. Perioper Med (Lond). .

Abstract

Background: The impact of intraoperative transfusion on postoperative mortality in lung transplant recipients is still elusive.

Methods: Univariate and multivariate analysis were performed to investigate the influence of red blood cells (RBCs) and fresh frozen plasma (FFP) on mortality in 134 consecutive lung transplants recipients from September 2003 until December 2008.

Results: Intraoperative transfusion of RBCs and FFP was associated with a significant increase in mortality with odds ratios (ORs) of 1.10 (1.03 to 1.16, P = 0.02) and 1.09 (1.02 to 1.15, P = 0.03), respectively. For more than four intraoperatively transfused RBCs multivariate analysis showed a hazard ratio for mortality of 3.8 (1.40 to 10.31, P = 0.003). Furthermore, non-survivors showed a significant increase in renal replacement therapy (RRT) (36.6% versus 6.9%, P <0.0001), primary graft dysfunction (PGD) (39.3% versus 5.9%, P <0.0001), postoperative need of extracorporeal membrane oxygenation (ECMO) (26.9% versus 3.1%, P = 0.0019), sepsis (24.2% versus 4.0%, P = 0.0004), multiple organ dysfunction syndrome (MODS) (26.9% versus 3.1%, P <0.0001), infections (18.1% versus 0.9%, P = 0.0004), retransplantation (12.1% versus 6.9%, P = 0.039) and readmission to the ICU (33.3% versus 12.8%, P = 0.024).

Conclusions: Intraoperative transfusion is associated with a strong negative influence on outcome in lung transplant recipients.

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Figures

Figure 1
Figure 1
Kaplan–Meier analysis with log rank test. There was a significantly lower cumulative 1-year survival in the group with transfusion of more than four RBCs (dashed line). RBC, red blood cell.
See this image and copyright information in PMC

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