TRADIFEG: Predictive Factors for Massive Transfusion During Liver Transplantation
Study Details
Study Description
Brief Summary
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.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
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.
Study Design
Outcome Measures
Primary Outcome Measures
- Mortality [90 days]
90-day postoperative mortality after liver transplantation
Secondary Outcome Measures
- Postoperative mechanical ventilation [48 hours]
Duration of invasive mechanical ventilation
- Intensive care unit stay [Days until discharge from ICU, an average of 5 days]
Duration of intensive care unit stay
- In-hospital stay [Days until discharge from the hospital, an average of 14 days]
Hospital stay duration after liver transplant
- Post-transplant complication [90 days]
90-day postoperative complications after liver transplantation
Eligibility Criteria
Criteria
Inclusion Criteria:
- Patients undergoing liver transplantation
Exclusion Criteria:
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Age <18 years
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Retransplantation within 30 days
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Combined kidney-liver transplantation
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Fondazione Policlinico Universitario A. Gemelli IRCCS | Rome | Italy | 00168 | |
| 2 | UOC Anestesia delle Chirurgie Generali e dei Trapianti, Fondazione Policlinico Universitario A. Gemelli IRCCS | Rome | Italy | 00168 |
Sponsors and Collaborators
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Investigators
- Principal Investigator: Paola Aceto, MD, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 4216