1. Association of intraoperative transfusion of blood products with mortality in lung transplant recipients
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Pascal Locher, Silvia R Cottini, Reto A. Schuepbach, Paul A Stehberger, Urs Wenger, Denise Weber, Mario Fasshauer, Markus Béchir, and University of Zurich
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medicine.medical_specialty ,Lung ,business.industry ,medicine.medical_treatment ,Research ,Transfusion ,610 Medicine & health ,Human physiology ,medicine.anatomical_structure ,Lung transplantation ,Postoperative mortality ,ICU complications ,Medicine ,Mortality ,10023 Institute of Intensive Care Medicine ,business ,Intensive care medicine - Abstract
Background The impact of intraoperative transfusion on postoperative mortality in lung transplant recipients is still elusive. Methods Univariate and multivariate analysis were performed to investigate the influence of red blood cells (RBCs) and fresh frozen plasma (FFP) on mortality in 134 consecutive lung transplants recipients from September 2003 until December 2008. Results Intraoperative transfusion of RBCs and FFP was associated with a significant increase in mortality with odds ratios (ORs) of 1.10 (1.03 to 1.16, P = 0.02) and 1.09 (1.02 to 1.15, P = 0.03), respectively. For more than four intraoperatively transfused RBCs multivariate analysis showed a hazard ratio for mortality of 3.8 (1.40 to 10.31, P = 0.003). Furthermore, non-survivors showed a significant increase in renal replacement therapy (RRT) (36.6% versus 6.9%, P P P = 0.0019), sepsis (24.2% versus 4.0%, P = 0.0004), multiple organ dysfunction syndrome (MODS) (26.9% versus 3.1%, P P = 0.0004), retransplantation (12.1% versus 6.9%, P = 0.039) and readmission to the ICU (33.3% versus 12.8%, P = 0.024). Conclusions Intraoperative transfusion is associated with a strong negative influence on outcome in lung transplant recipients.
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