Predictive Factors for Massive Transfusion During Liver Transplantation

Study Overview
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Brief Summary
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Liver transplantation (LT) is the treatment of choice for patients with end-stage liver disease (1). LT is often associated with severe intraoperative blood loss and the literature has had a great interest in clarifying the predictive factors for transfusion requirements during this surgery. Despite the advances in surgical techniques, graft preservation, and anesthetic management achieved over the past two decades, intraoperative bleeding and blood component consumption during LT are still issues of current interest. The requirement for blood components is highly variable between different transplant centers and ranges from none to many units of red blood cells (RBC), plasma, and platelets per patient. Bleeding associated with LT is multifactorial. Among the pre-transplantation factors, portal hypertension and coagulation defects are of great importance. The latter can develop or amplify during the anaepatic and/or neohepatic phase due to the absence of hepatic metabolic function, hyperfibrinolysis or platelet sequestration in the graft. In the literature, the higher transfusion requirement (HTR) is associated with worse postoperative outcomes, with an increase in both the length of stay in the intensive care unit (ICU) and in hospital, and mortality.

Detailed Description
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The aim of this study is to evaluate the influence of increased transfusion requirements on the prognosis of patients undergoing LT and the risk factors for HTR. HTR is defined as the consumption of packed red blood cells (GRC) ≥ 5 units in the first 24 hours of surgery.

Official Title
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Predictive Factors for Massive Transfusion During Liver Transplantation: an Observational Study

Conditions
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Liver Transplant; Complications

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients undergoing liver transplantation Exclusion Criteria: Age <18 years Retransplantation within 30 days Combined kidney-liver transplantation

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality | 90-day postoperative mortality after liver transplantation | 90 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative mechanical ventilation | Duration of invasive mechanical ventilation | 48 hours | 
| Intensive care unit stay | Duration of intensive care unit stay | Days until discharge from ICU, an average of 5 days | 
| In-hospital stay | Hospital stay duration after liver transplant | Days until discharge from the hospital, an average of 14 days | 
| Post-transplant complication | 90-day postoperative complications after liver transplantation | 90 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Transfusions, Mortality