• J. Cardiothorac. Vasc. Anesth. · Apr 2021

    Effect of Blood Product Transfusion on Perioperative Outcomes After Heart Transplantation.

    • Kathirvel Subramaniam, Akshay Kumar, Sergio Hernandez, and Seyed Mehdi Nouraie.
    • Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA. Electronic address: subramaniamk@upmc.edu.
    • J. Cardiothorac. Vasc. Anesth. 2021 Apr 1; 35 (4): 1067-1072.

    Objective(S)The objective of this study was to identify transfusion-related in-hospital outcomes in orthotopic heart transplantation (OHT) recipients.DesignRetrospective chart review.SettingTertiary care hospital.ParticipantsAdult OHT recipients undergoing transplantation between January 2010 and December 2016.InterventionsNone.Measurements And Main ResultsThe primary composite outcome was occurrence of any of the following events during admission for OHT: (1) graft dysfunction requiring mechanical circulatory support (MCS); (2) respiratory failure requiring tracheostomy; (3) renal failure requiring hemodialysis; (4) 30-day mortality; (5) complication requiring readmission to intensive care unit; (6) sepsis; and (7) stroke. The authors evaluated these outcomes in relation to all blood component transfusions received intraoperatively and in the first 24 hours postoperatively. The study included 197 patients and the primary composite outcome was present in 72 (36.6%). After adjusting for propensity score, red blood cell (RBC) transfusion was associated with composite outcomes (odds ratio [OR] 1.17, 95% confidence interval [CI] 1.05-1.31, p = 0.004), postoperative MCS use (OR 1.36, 95% CI 1.18-1.58, p < 0.001), acute renal failure requiring hemodialysis (OR 1.21, 5% CI 1.06-1.38, p = 0.004), and 30-day mortality (OR 1.29, 95% CI 1.05-1.59, p = 0.02). Fresh frozen plasma was associated with composite outcome (OR 1.07, 95% CI [1.003-1.15], p = 0.042) and renal failure (OR 1.08, 95% CI 1.08 [1.002-1.17], p = 0.04).ConclusionsIntra- and postoperative transfusions (first 24 hours) of RBC and FFP were associated with adverse postoperative composite outcomes in patients undergoing OHT.Copyright © 2020 Elsevier Inc. All rights reserved.

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