Blood transfusion of the donor is associated with stage 3 primary graft dysfunction after lung transplantation

Abstract

Background:The first aim of this study was to assess the association between stage 3 PGD and pre-donation blood transfusion of the donor. The secondary objectives were to assess the epidemiology of donor transfusion and the outcome of LT recipients according to donor transfusion status and massive donor transfusion status.Methods: This was an observational, prospective, single-center study. The results are expressed as absolute numbers, percentages, medians, and interquartile ranges. Statistical analyses were performed using Chi squared, Fischer's exact tests, and Mann-Whitney U tests (P < .05 was considered significant). A multivariate analysis was performed. Results:Between January 2016 and February 2019, 147 patients were included in the analysis. PGD was observed in 79 (54%) patients, 45 (31%) of whom had stage 3 PGD.Pre-donation blood transfusion was administered in 48 (33%) donors (median of 3[1-9] packed red cells (PRCs)). On multivariate analysis, stage 3 PGD was significantly associated with donor blood transfusion (OR 2.69,), P = .024). Mortality at days 28 and 90 was not significantly different according to the pre-donation transfusion status of the donor. Conclusion:Pre-donation blood transfusion is associated with stage 3 PGD occurrence after LT. Transfusion data of the donor should be included in donor lung assessment.

Evaluation of red blood cell transfusion threshold in the management of brain-dead organ donors

“…Furthermore, these complications lead to primary graft dysfunction and recipient mortality. [28–30] We did not investigate the influence of transfusion on recipient prognosis; nonetheless, our findings provided the evidence for justifying the restriction of transfusion at a hemoglobin concentration of 7 g/dL.…”

New Aspects of Lung Transplantation: A Narrative Overview Covering Important Aspects of Perioperative Management

“…Perioperative transfusion of allogeneic blood products in both donor [ 21 , 22 , 23 ] and recipient has been widely associated with an increased risk of primary graft dysfunction (PGD) and 1-year mortality [ 24 , 25 , 26 ]. While these studies have highlighted an association between transfusion and poorer outcomes, it is difficult to determine whether the impact of transfusion is related to the nature of the products administered or to the bleeding that led to the transfusion.…”

Low HDL-Cholesterol Concentrations in Lung Transplant Candidates are Strongly Associated With One-Year Mortality After Lung Transplantation

“…Unlike atherosclerosis or sepsis, where both HDL-C concentration and HDL particle functionality have been extensively studied (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25), only a few studies have reported HDL-C levels in the context of respiratory disease and LT (26). A retrospective analysis of 126 consecutive individuals evaluated for LT with a diagnosis of COPD showed that HDL-C levels were increased and this was partially attributable to oral steroid use (27).…”

“…The selection of lung transplant candidates (16) and perioperative care (17)(18)(19)(20) was standardized for all patients according to current practices. During the intraoperative period, haemodynamic status was monitored using invasive arterial blood pressure, central venous and Swan Ganz catheters, and trans-oesophageal echocardiography.…”