Unit:
Κατεύθυνση Θρόμβωση-Αιμορραγία-Ιατρική των μεταγγίσεωνLibrary of the School of Health Sciences
Author:
Koziakas Ilias-Georgios
Supervisors info:
Δημήτριος Δημητρούλης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Ματσώτα Παρασκευή, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Βαλσάμη Σερένα, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Διεγχειρητική μετάγγιση και χορήγηση παραγόντων σε ηπατεκτομές και μεταμοσχεύσεις ήπατος στο ΓΝΑ Λαϊκό
Translated title:
Intraoperative blood transfusion and provision of haemostatic agents in hepatectomies and liver transplantations in Laikon General Hospital
Summary:
Introduction: Transfusion of allogenic blood components in patients undergoing liver transplantation and hepatectomy is related to higher rates of postoperative complications and worse outcomes.
Purpose: Investigation of the frequency of intraoperative blood transfusion in patients who underwent hepatic resection and liver transplantation and correlation of intraoperative blood transfusion with the outcome and hospital stay of these patients.
Methodology –Sample: A retrospective cohort study has taken place for the time interval of 1/9/2017 to 30/9/2018.The sample of the study were 82 adult patients who underwent hepatic resection or liver transplantation in ‘Laikon’ General Hospital of Athens. Patients who deceased during the operation and those who underwent emergency surgical operation were not included in the study. Collection of data was fulfilled through research of the medical records of patients and also the online data from the blood center of the hospital. A special recording sheet was filled with the demographics, clinical and laboratory data of patients. Statistical analysis was made with SPSS 24.0 and statistical importance was set at p-value≤0.05.
Results: 95.1% of patients in the study underwent hepatectomy and 4.9% liver transplantation. 45.1% of patients were male and the median age (±ΤΑ) was 60.7(±12.3) years. All patients who underwent liver transplantation were transfused intraoperatively, while out of those who underwent hepatectomy 56.1% received transfusion. The average number of transfused units of RBC [8.00(±5.4) vs 2.09(±1.3), p=0.003] and that of FFP [10.00(±5.3) vs 2.72(±1.4), p=0.003] intraoperatively were substantially greater in patients who underwent liver transplantation compared to those who underwent hepatectomy. The type of hepatectomy (p=0.003), type (p=0.003) and duration of surgery (p=0.001) and preoperative platelet count (p=0.033) were associated strongly with intraoperative transfusion although , only the duration of the operation was able to independently predict intraoperative transfusion in the multifactorial analysis [RR(95%CI)=0.643(0.477-0.868), p=0.004]. Length of hospital stay was strongly associated with type (p=0.000) and duration of surgery (p=0.001), intraoperative transfusion (p=0.000), the number of transfused RBC units (p=0.000), FFP units (p=0.000) and the postoperative change in Hgb (p=0.001). During the multifactorial analysis only the duration of surgery could independently predict the length of hospital stay of patients [RR(95%CI)=2.010(0.871-3.150), p=0.004]. Intraoperative transfusion was not associated with higher mortality (p>0.05).
Conclusions: An important percentage of patients who undergo hepatic resection and liver transplantation receive transfusion intraoperatively. Blood transfusion was associated with prolonged hospital stay but did not affect the outcome of patients in our study.
Main subject category:
Science
Keywords:
Hepatectomy, Transplantation, Hemostasis, Hemorrhage
