Factors in Association With Sepsis After Liver Transplantation: The Hungarian Experience

Nemes, Balázs; Sárváry, Enikő; Sótonyi, Péter; Gerlei, Zs.; Doros, Attila; Gálffy, Zsuzsa; Fehérvári, Imre; Fazakas, János; Járay, J.; Kopper, László

doi:10.1016/j.transproceed.2005.03.067

Cited by 13 publications

(11 citation statements)

References 13 publications

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“…Septicemia had been the major leading cause to mortality in patients who had massive blood transfusion during operation period of transplantation surgeries (Devi et al, 2009;George et al, 1991;Nemes et al, 2005). Graft rejection was also one of the detrimental events in those who underwent orthotopic transplantation.…”

Section: Discussionmentioning

confidence: 99%

Clinical Practice of Blood Transfusion in Orthotopic Organ Transplantation: A Single Institution Experience

Tsai

Hsieh²,

Chang³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Orthotopic organ transplantation, a treatment option for irreversible organ dysfunction according to organ failure, severe damaged organ or malignancy in situ, was usually accompanied with massive blood loss thus transfusion was required. We aimed to evaluate the adverse impact of blood transfusion on solid organ transplantation. Materials and Methods: From January, 2009 to December, 2014, patients who received orthotopic organ transplantation at Far Eastern Memorial Hospital medical center were enrolled. Clinical data regarding anemia status and red blood cell (RBC) transfusion before, during and after operation, as well as patient outcomes were collected for further univariate analysis. Results: A total of 105 patients who underwent orthotopic transplantation, including liver, kidney and small intestine were registered. The mean hemoglobin (Hb) level upon admission and before operation were 11.6±1.8 g/dL and 11.7±1.7 g/dL, respectively; and the nadir Hb level post operation and the final Hb level before discharge were 8.3±1.6 g/dL and 10.2±1.6 g/dL, respectively. The median units (interquartile range) of RBC transfusion in pre-operative, peri-operative and post-operative periods were 0 (0-0), 2 (0-12), and 2 (0-6) units, respectively. Furthermore, the median (interquartile range) length of hospital stay (LHS) from admission to discharge and from operation to discharge were 28 (17-44) and 24 (16-37) days, respectively. Both peri-operative and post-operative RBC transfusion were associated with longer LHS from admission to discharge and from operation to discharge. Furthermore, it increased the risk of post-operative septicemia. While peri-operative RBC transfusion elevated the risk of acute graft rejection in patients who received orthotopic transplantation. Conclusions: Worse outcome could be anticipated in those who had received massive RBC transfusion in transplantation operation. Hence, peri-operative RBC transfusion should be avoided as much as possible.

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Section: Discussionmentioning

confidence: 99%

Clinical Practice of Blood Transfusion in Orthotopic Organ Transplantation: A Single Institution Experience

Tsai

Hsieh²,

Chang³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…Additionally, Vera and associates 20 and Shen and associates 32 found that transfusion of > 1000 mL of blood during an operation was an independent risk factor for postoperative infection. Nemes and associates 33 identified risk factors for sepsis after LT in 199 patients. Sepsis was detected in 45 patients (23%) with a mean intraoperative RBC transfusion of 15 ± 8 U, whereas patients without sepsis had received a mean of 10 ± 6.4 U (P = .001).…”

Section: Discussionmentioning

confidence: 99%

Effects of Blood Products on Nosocomial Infections in Liver Transplant Recipients

Özkardeşler

Avkan-Oğuz²,

Akan³

et al. 2013

Exp Clin Transplant

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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.

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“…In such patients, dissection of adhesions with collaterals resulting from the portal hypertension can add to the amount of blood loss. In SEB, HAES was used intraoperatively [38] and postoperatively as well. The bleeding tendency after OLT is a critical point.…”

Section: Discussionmentioning

confidence: 99%

Analysis of differences in outcome of two European liver transplant centers

Nemes¹,

Polak²,

Ther³

et al. 2006

Transplant Int

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Summary Authors analyzed the differences in the outcome of two European liver transplant centers differing in case volume and experience. The first was the Transplantation and Surgical Clinic, Semmelweis University, Budapest, Hungary (SEB) and the second the University Medical Center Groningen, Groningen, The Netherlands (UMCG). We investigated if such differences could be explained. The 1‐, 3‐ and 5‐year patient survival in the UMCG was 86%, 80%, and 77% compared with 65%, 56%, and 55% in SEB. Graft survival at the same time points was 79%, 71%, and 66% in the UMCG and 62%, 55%, and 53% in SEB. Significant differences were present regarding the donor and recipient age, diagnosis mix, disease severity and operation variables, per‐operative transfusion rate, vascular complications, postoperative infection rate, and need for renal replacement. To determine factors correlating with survival, a separate uni‐ and multivariate analysis was performed in each center individually, between study parameters and patient survival. In both centers, peri‐operative red blood cell (RBC) transfusion rate was a significant predictor for patient survival. The difference in blood loss can be explained by different operation techniques and shorter operation time in SEB, with consequently less time spent on hemostasis. It was jointly concluded that measures to reduce blood loss by adapting the operation technique might lead to improved survival and reduced morbidity.

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Factors in Association With Sepsis After Liver Transplantation: The Hungarian Experience

Cited by 13 publications

References 13 publications

Clinical Practice of Blood Transfusion in Orthotopic Organ Transplantation: A Single Institution Experience

Clinical Practice of Blood Transfusion in Orthotopic Organ Transplantation: A Single Institution Experience

Effects of Blood Products on Nosocomial Infections in Liver Transplant Recipients

Analysis of differences in outcome of two European liver transplant centers

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