Massive intraoperative red blood cell transfusion during lung transplantation is strongly associated with 90-day mortality

Prolonged mechanical ventilation after lung transplantation: risks factors and consequences on recipient outcome

“…Perioperative management of LT is standardised in our centre, according to our local protocol ( 6 , 7 ) and current practises ( 8 ). After lung removal, graft preservation was performed by administration of preservation fluid (Perfadex ®) –4 l anterograde administration followed by 2 l retrograde administration.…”

“…During the surgical procedure, invasive arterial pressure, Swan Ganz catheter, and transoesophageal echocardiography were used for haemodynamic monitoring and optimisation of fluid administration. A restrictive transfusion threshold (haemoglobin concentration < 7 g/dL) was used for red blood cell (RBC) transfusion ( 7 ). An autotransfusion system (Cell-saver®, Fresenius, Bad Homburg vor der Höhe, Germany) was used, and tranexamic acid was administered in the absence of contraindications.…”

Examining Bleeding Risk, Transfusion-related Complications, and Strategies to Reduce Transfusions in Lung Transplantation

“…"Large volume" transfusion of red cells intraoperatively (more than 1 l) is one commonly selected description for clinically significant bleeding. 11 In other single-center studies in lung transplantation, massive transfusion was defined as an intraoperative erythrocyte unit requirement more than 5 U, 25 and another defined it as more than 10 U in 24 h. 26 A summary of published measures and definitions of bleeding applicable to lung transplantation can be seen in table 1.…”

“…[46][47][48][49] Massive transfusion during lung transplantation has an incidence of approximately 18 to 27% and is associated with a higher 90-day mortality. 25,26 In a monocentric cohort of lung transplantation, transfusion was more frequent in cystic fibrosis and pulmonary fibrosis patients, potentially due to the need for mechanical support intraoperatively and/or a history of previous thoracic surgery in the pulmonary fibrosis cohort. Preoperative anemia, extremes of body mass index, and pleural adhesions secondary to chronic pleural inflammation in the cystic fibrosis group was also associated with transfusions.…”

“…46–49 Massive transfusion during lung transplantation has an incidence of approximately 18 to 27% and is associated with a higher 90-day mortality. 25,26…”