Objective:

To identify independent risk factors for intraoperative blood transfusion in liver transplant patients and to explore the effect of intraoperative blood transfusion on postoperative acute kidney injury (AKI) and in-hospital mortality.

Approach:

Key Findings:

• Independent risk factors for intraoperative blood transfusion included sex, weight, liver cancer, alcoholic hepatitis, Child-Pugh classification, anhepatic phase, and intraoperative bleeding.
• In the unmatched cohort, intraoperative blood transfusion was associated with increased risk of postoperative AKI (OR 2.993, 95% CI 2.061–4.347) and in-hospital mortality (OR 2.692, 95% CI 1.313–5.522).
• In the matched cohort, intraoperative blood transfusion was associated with increased risk of postoperative AKI (OR 1.861, 95% CI 1.053–3.290) but not with in-hospital mortality (OR 1.000, 95% CI 0.281–3.562).
• After multivariable regression in the matched cohort, intraoperative blood transfusion was no longer an independent risk factor for postoperative AKI and hospital mortality.

Interpretation:

Intraoperative allogeneic blood transfusion does not influence postoperative acute kidney injury and in-hospital mortality in liver transplantation patients based on the study findings.

Limitations:

• The study is retrospective and may have confounding variables that could affect the results.
• Findings need validation through multicenter, prospective studies.

Conclusion:

The majority of patients received no more than 8 units of blood, suggesting that intraoperative blood transfusion may not significantly impact postoperative outcomes.

Sources:

• Clinical Trial Registration
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