Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/615
Título: Predictive Variables Affecting Transfusion Requirements in Orthotopic Liver Transplantation
Autor: Araújo, T
Cordeiro, A
Proença, P
Perdigoto, R
Martins, A
Barroso, E
Palavras-chave: Transfusão de Eritrócitos
Estatística
Hemoglobinas
Transplantação de Fígado
Efeitos Adversos
Contagem de Plaquetas
Valor Preditivo dos Testes
Tempo de Protrombina
Estudos Retrospectivos
Factores de Risco
Data: 2010
Editora: Elsevier
Citação: Transplant Proc. 2010 Jun;42(5):1758-9.
Resumo: INTRODUCTION AND AIMS: Adult orthotopic liver transplantation (OLT) is associated with considerable blood product requirements. The aim of this study was to assess the ability of preoperative information to predict intraoperative red blood cell (RBC) transfusion requirements among adult liver recipients. METHODS: Preoperative variables with previously demonstrated relationships to intraoperative RBC transfusion were identified from the literature: sex, age, pathology, prothrombin time (PT), factor V, hemoglobin (Hb), and platelet count (plt). These variables were then retrospectively collected from 758 consecutive adult patients undergoing OLT from 1997 to 2007. Relationships between these variables and intraoperative blood transfusion requirements were examined by both univariate analysis and multiple linear regression analysis. RESULTS: Univariate analysis confirmed significant associations between RBC transfusion and PT, factor V, Hb, Plt, pathology, and age (P values all < .001). However, stepwise backward multivariate analysis excluded variables Plt and factor V from the multiple regression linear model. The variables included in the final predictive model were PT, Hb, age, and pathology. Patients suffering from liver carcinoma required more blood products than those suffering from other pathologies. Yet, the overall predictive power of the final model was limited (R(2) = .308; adjusted R(2) = .30). CONCLUSION: Preoperative variables have limited predictive power for intraoperative RBC transfusion requirements even when significant statistical associations exist, identifying only a small portion of the observed total transfusion variability. Preoperative PT, Hb, age, and liver pathology seem to be the most significant predictive factors but other factors like severity of liver disease, surgical technique, medical experience in liver transplantation, and other noncontrollable human variables may play important roles to determine the final transfusion requirements.
Peer review: yes
URI: http://hdl.handle.net/10400.17/615
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