Effects of Blood Products on Nosocomial Infections in Liver Transplant Recipients

Abstract

Objectives: Infection is the most severe complication after an organ transplant. Blood cell transfusion is an independent risk factor for adverse events, including infection in the recipient. This study sought to evaluate the effect of blood product transfusions on nosocomial infections in liver transplant patients. Materials and Methods: Patients who underwent a liver transplant at our hospital between 2003 and 2010 were recruited for this study. Exclusion criteria were incomplete records, patients who were hospitalized for more than 48 hours during the 4 weeks before transplant, and pediatric transplants. Incidence of nosocomial infections, which were defined as infections occurring within 30 days after transplant was the primary endpoint. Results: The incidence of nosocomial infections was 28.7%. The number of transfusions of packed red blood cells and fresh frozen plasma was significantly higher in patients with nosocomial infection compared with patients without nosocomial infection (P = .018 and P = .039). Blood products dose-dependently contributed to nosocomial infections. Transfusions of ≥ 7.5 units of red blood cells (odds ratio: 2.8) or ≥ 12.5 units of fresh frozen plasma (odds ratio: 3.27) were associated with nosocomial infections (P = .042 and P = .015). The infection-related mortality rate was 10.3%. Conclusions: Blood product transfusions are associated with an increased rate of nosocomial infections, which contributes to higher morbidity and mortality.

Infecções Relacionadas À Assistência À Saúde E Fatores Associados No Pós-Operatório De Transplante Hepático

“…Of the infected patients, sixteen (55.1%) were associated with pathogens, while the remaining thirteen patients had only clinical signs of infection. 4 These findings corroborate the data from the present study, which presented a 28.3% infection rate among the study participants, and the majority (56.3%) had positive culture results.…”

“…This fact may be associated with the small number of transfusions in the sample or with autologous transfusion, which is performed during the LT of the hospital institution of this study, through a process of blood collection and reinfusion, with the objective of reducing and, if possible, eliminating the need for allogeneic blood transfusion, reducing the probable infectious and noninfectious complications. 17 Researches carried out with liver receptors have identified that the transfusion of blood products was associated with the development of PO infection, which contributes to increased morbidity and mortality after LT. 4,12,18 The length of stay in the PO was greater among patients who have acquired HCRI in comparison to those who have not acquired it, showing statistically significant association. These findings corroborate the result of another study that points to the prolonged time of hospitalization as a risk factor for the development of HCRI in liver recipients, conducted in a university hospital located in Korea, where 144 patients were assessed.…”

“…3 Liver receptors have a higher incidence of infectious complications due to the seriousness of their condition and the complexity of the surgical procedure, affecting from 8% to 40% of the patients, with a mortality rate of 15% to 36%. 4 The evolution in the immunosuppressive therapy has reduced the incidence of rejection, however, the vulnerability to opportunistic infections and infections by multiresistant pathogens are complications of relevance and significant impact. 3 The literature shows that during the first postoperative (PO) month, the risk of Health CareRelated Infections (HCRI) predominates.…”

Incidence, influencing factors, and prognostic impact of intraoperative massive blood loss in adolescents with neuromuscular scoliosis

“…[4,5] However, neither intraoperative massive blood loss nor blood product transfusion is without risks. [6,7] Both may adversely affect postoperative outcomes, increase health care costs, and prolong hospitalization. [8] Therefore, identifying factors influencing intraoperative massive blood loss in patients undergoing scoliosis surgery is vital to establish an optimal blood conservation strategy in an era of blood supply shortage.…”

Predicting packed red blood cell transfusion in living donor liver transplantation: A retrospective analysis

“…[ 6 ] In this regard, identifying predictors of MT is an area of continuous research. Considering 1-year graft survival is decreased in recipients receiving more than four units of blood transfusion,[ 13 ] we conducted this retrospective analysis to identify factors which could predict the need for transfusion of more than four PRBCs intraoperatively. Forty-three perioperative factors of patients who underwent LDLT over 5 and half years at a single centre in India were analysed.…”