ORIGINAL RESEARCH ARTICLE

Factors associated with the need for intraoperative packed red cells transfusion in pediatric liver transplant patients

Christopher Kapuangan , Arie Utariani, Elizeus Hanindito

Christopher Kapuangan
Department of Anesthesiology and Intensive Care, Cipto Mangkunkusumo Hospital. Email: mayuputeri@yahoo.com

Arie Utariani
Department of Anesthesiology and Reanimation, Medical Faculty of Airlangga University – Dr.Soetomo General Hospital, Surabaya-Indonesia

Elizeus Hanindito
Department of Anesthesiology and Reanimation, Medical Faculty of Airlangga University – Dr.Soetomo General Hospital, Surabaya-Indonesia
Online First: April 30, 2019 | Cite this Article
Kapuangan, C., Utariani, A., Hanindito, E. 2019. Factors associated with the need for intraoperative packed red cells transfusion in pediatric liver transplant patients. Bali Journal of Anesthesiology 3(1): 69-73. DOI:10.15562/bjoa.v3i1.143


Background: Massive hemorrhage is one of the most common problems encountered during a liver transplantation procedure. Correction of the blood loss using packed red cells (PRC) is essential during the procedure to improve outcome. This retrospective study aims to investigate preoperative and intraoperative factors that may predict the PRC need.

Materials and Methods: Thirty-four patients who underwent pediatric liver transplantation procedure within 2010-2018 were included in this study. Their medical record was examined and the data was analyzed using a comparison of mean and regression model.

Results: The mean bleeding in this study was found to be 906.62±674.30 mL, while the mean PRC transfusion was 566.71±307.30 mL. Correction of blood loss was also compensated with other means such as a crystalloid or colloid fluid.

Conclusion: This study statistically demonstrated that pre-operative weight, as well as bleeding volume, significantly affect the PRC transfusion requirement (p <0.05). However, other factors such as hemoglobin and surgical duration may also be clinically significant factors to predict PRC transfusion need.

References

REFERENCES

Meirelles RFJ, Sevalaggio P, Rezende MB, et al. Liver transplantation: history, outcomes, and perspectives. Einstein. 2015; 13(1): 149-152. DOI: 10.1590/S1679-45082015RW3164

Groenland THN, Porte RJ, Metselaar HJ. Liver transplantation and risk of bleeding. Curr Opin in Organ Transplantation. 2007; 12(3): 287-293. DOI: 10.1097/MOT.0b013e32814e6bb0

Devi AS. Transfusion practice in orthotopic liver transplantation. Indian J Crit Care Med. 2009; 13(3): 120-128. DOI: 10.4103/0972-5229.58536

Rana A, Kaplan B, Jie T, et al. A critical analysis of early death after adult liver transplants. Clin Transplant. 2013; 27(4): E448-53. DOI: 10.1111/ctr.12186

Weismuller TJ, Fikatas P, Schmidt J, et al. Multicentric evaluation of a model for end-stage liver disease-based allocation and survival after liver transplantation in Germany—limitations of the ‘sickest first’-concept. Transpl Int. 2011; 24: 91–99. DOI: 10.1111/j.1432-2277.2010.01161.x

Farmer DG, Vernick RS, McDiarmid SV, et al. Predictors of outcomes after pediatric liver transplantation: an analysis of more than 800 cases. J Am Coll Surg. 2007; 204(5): 904-14. DOI: 10.1016/j.jamcollsurg.2007.01.061

Pawlowska J. The importance of nutrition for pediatric liver transplant patients. Clin Exp Hepatol. 2016; 2(3): 105-108. DOI: 10.5114/ceh.2016.61665

Fieldman AG, Mack CL. Biliary atresia: clinical lessons learned. J Ped Gastroenterol Nutrition. 2015; 61(2): 167-175. DOI: 10.1097/MPG.0000000000000755

Jin SJ, Kim SK, Choi SS, et al. Risk factors for intraoperative massive transfusion in pediatric liver transplantation: a multivariate analysis. Int J Med. 2017; 14(2): 173-180. DOI:10.7150/ijms.17502

Blain S, Paterson N. Paediatric massive transfusion. BJA Edu. 2015; 18(8): 269-275. DOI: 10.1093/bjaed/mkv051

Turan A, Yang D, Bonilla A, et al. Morbidity and mortality after massive transfusion in patients undergoing non-cardiac surgery. Can J Anaesth. 2013; 60(8): 761-770. DOI: 10.1007/s12630-013-9937-3

Nacoti M, Cazzaniga S, Lorusso F, et al. The impact of perioperative transfusion of blood products on survival after pediatric liver transplantation. Pediatr Transplantation. 2012; 16: 357-366. DOI: 10.1111/j.1399-3046.2012.01674.x

Ulukaya S, Acar L, Ayanoglu HO. Transfusion requirements during cadaveric and living donor pediatric liver transplantation. Pediatr Transplantation. 2005; 9: 332-337. DOI: 10.1111/j.1399-3046.2005.00284.x

Jin SJ, Kim SK, Choi SS, et al. Risk factors for intraoperative massive transfusion in pediatric liver transplantation: a multivariate analysis. Int J Med. 2017; 14(2): 173-180. DOI: 10.7150/ijms.17502


No Supplementary Material available for this article.
Article Views      : 262
PDF Downloads : 116