The Association of Increased FFP:RBC Transfusion Ratio to Primary Graft Dysfunction in Bleeding Lung Transplantation Patients.
J Cardiothorac Vasc Anesth
; 34(11): 3024-3032, 2020 Nov.
Article
en En
| MEDLINE
| ID: mdl-32622711
ABSTRACT
OBJECTIVES:
Lung transplantation is associated with a significant risk of needed transfusion. Although algorithm-based transfusion strategies that promote a high fresh frozen plasmared blood cells (FFPRBC) ratio have reduced overall blood product requirements in other populations, large-volume transfusions have been linked to primary graft dysfunction (PGD) in lung transplantation, particularly use of platelets and plasma. The authors hypothesized that in lung transplant recipients requiring large-volume transfusions, a higher FFPRBC ratio would be associated with increased PGD severity at 72 hours.DESIGN:
Observational retrospective review.SETTING:
Single tertiary academic center.PARTICIPANTS:
Adult patients undergoing bilateral or single orthotopic lung transplantation and receiving >4 U PRBC in the first 72 hours from February 2014 to March 2019.INTERVENTIONS:
None. MEASUREMENTS AND MAINRESULTS:
Patient demographics, operative characteristics, blood transfusions, and outcomes including PGD scores and length of stay were collected. Eighty-nine patients received >4U PRBC, had available 72-hour PGD data, and were included in the study. These patients were grouped into a high-ratio (>12 units of FFPRBC, Nâ¯=â¯38) or low-ratio group (<12 units of FFPRBC, Nâ¯=â¯51). Patients in the high-ratio group received more transfusions and factor concentrates and had significantly longer case length. The high-ratio group had a higher rate of severe PGD at 72 hours (60.5% v 23.5%, pâ¯=â¯0.0013) and longer hospital length of stay (40 v 32 days, pâ¯=â¯0.0273).CONCLUSIONS:
In bleeding lung transplantation patients at high risk for PGD, a high FFPRBC transfusion ratio was associated with worsened 72-hour PGD scores when compared with the low-ratio cohort.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Trasplante de Pulmón
/
Disfunción Primaria del Injerto
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Cardiothorac Vasc Anesth
Asunto de la revista:
ANESTESIOLOGIA
/
CARDIOLOGIA
Año:
2020
Tipo del documento:
Article