Predictive factors associated with re-exploration for hemostasis in living donor liver transplantation
| Autor: | Chia-Jung Huang, Bruno Jawan, Kwok-Wai Cheng, Tsung-Hsiao Shih, Shao-Chun Wu, Johnson Chia-Shen Yang, Chih-Hsien Wang, Chao-Long Chen |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Blood transfusion Adolescent medicine.medical_treatment Blood Loss Surgical Postoperative Hemorrhage Liver transplantation Perioperative Care Plasma Young Adult Risk Factors Ascites Living Donors medicine Humans Blood Transfusion Child Retrospective Studies Transplantation business.industry Incidence (epidemiology) General Medicine Middle Aged Hemostasis Surgical Liver Transplantation Surgery Logistic Models Child Preschool Cryoprecipitate Hemostasis Female Fresh frozen plasma medicine.symptom business Body mass index |
| Zdroj: | Annals of Transplantation. 17:64-71 |
| ISSN: | 1425-9524 |
| Popis: | After liver transplantation (LT), re-exploration of the abdomen to check for bleeding is sometime required. Our study aimed to identify the predictive factors by analysis of preoperative and intraoperative presentations that may impact the re-exploration for hemostasis.We selected 522 consecutive recipients from the Liver Transplant Program database and medical records between January 1, 1994 and December 1, 2009 in our hospital. Demographic data (age, sex, body mass index, weight, MELD score), preoperative laboratory tests (Hb, platelet, albumin, bilirubin, INR, APTT), and intraoperative presentations (ascites and blood loss, crystalloids, 5% albumin infused, blood products used (such as LPRBC, RBC, FFP, platelet, cryoprecipitate), urine output, Hb at end of operation, and anesthesia) were collected for primary comparison. Potential predictors found by univariate comparison at p0.1 were put into a multiple binary logistic regression model.Thirty-eight (7.3%) recipients required re-exploration for hemostasis after LDLT; 80% needed re-exploration only once. In univariate analysis, recipients transfused with FFP10 ml/kg had a 4.2-fold increased risk of re-exploration (p0.001). Thirteen potential predictors by univariate comparison at p0.1 were selected into a multiple binary logistic regression. Fresh frozen plasma (FFP) transfused was the sole predictor.Each elevation of 1ml of transfused FFP per kg is associated with a 1.033-fold increased incidence of re-exploration for hemostasis. Patients transfused with more than 10 ml/kg FFP during LT require more intensive management within 72 hours due to increase risk of postoperative bleeding. |
| Databáze: | OpenAIRE |
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