Perioperative red blood cell transfusion and mortality following heart transplantation: A retrospective nationwide population‐based study between 2007 and 2016 in Korea

Nam, Karam; Jang, Eun Jin; Kim, Ga Hee; Yhim, Hyung Been; Lee, Hannah; Kim, Dal Ho; Ryu, Ho Geol

doi:10.1111/jocs.14148

Cited by 16 publications

(5 citation statements)

References 36 publications

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“…30 Additionally, in a recent study with 833 patients undergoing heart transplantation only transfusions exceeding six units of PRBC have been linked to worse outcome. 31 As mentioned above, a similar threshold can be seen in our data. In liver transplantation, preoperative anemia did not impair survival compared to preoperatively non-anemic patients who received less units of PRBC intraoperatively.…”

Section: Discussionsupporting

confidence: 90%

Initial Postoperative Hemoglobin Values Are Independently Associated With One-Year Mortality in Patients Undergoing Double-Lung Transplantation Requiring Intraoperative Transfusion

Menger

Koch

Mouhieddine

et al. 2021

Journal of Cardiothoracic and Vascular Anesthesia

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Section: Discussionsupporting

confidence: 90%

Initial Postoperative Hemoglobin Values Are Independently Associated With One-Year Mortality in Patients Undergoing Double-Lung Transplantation Requiring Intraoperative Transfusion

Menger

Koch

Mouhieddine

et al. 2021

Journal of Cardiothoracic and Vascular Anesthesia

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“…Furthermore, in a 2019 study of 833 heart transplant recipients in Korea, Nam et al. observed significantly increased in‐hospital mortality, ICU length of stay, and hospital length of stay in patients transfused with ≥6 units of pRBC 12 . The data overall suggests that transfusion amount is a risk factor for PGD.…”

Section: Discussionmentioning

confidence: 99%

Increased severe primary graft dysfunction in left ventricular assist device patients following united network for organ sharing allocation changes

Guo

Kotkar

Jocher

et al. 2022

Clinical Transplantation

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Introduction In 2018, the United Network for Organ Sharing (UNOS) implemented a new heart allocation system which prioritized patients on temporary support devices and left‐ventricular assist device (LVAD) patients with complications. These changes have the potential to impact outcomes for patients bridged to transplant with an LVAD. Methods We performed a retrospective study of 168 adult heart transplant recipients at our center between 2016 and 2020 evaluating post‐transplant outcomes before and after UNOS allocation changes. Donor and recipient data were retrieved from chart review and national databases. The primary outcome of this study was severe primary graft dysfunction (PGD) with secondary outcomes of 30‐day readmission, 30‐day mortality, and 1‐year mortality. Results Incidence of severe PGD was similar in the overall cohort before and after the changes (10% vs. 15%, respectively, p = .3) and increased in the LVAD‐bridged cohort (12% vs. 40%, respectively, p < .01). Secondary outcomes of readmission and survival were similar between all groups. Blood transfusion was predictive of severe PGD in multivariable modeling (OR 1.3 [1.11–1.59], p < .01).

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“…Despite publication of transfusion practice guidelines [14], there is considerable variation in hospital transfusion rates [22]. In the context of CT, there is limited evidence regarding transfusion rates [4,5,23], particularly concerning patients on anticoagulation or antiplatelet regimens during CT waitlist. In the absence of specific data, a restrictive erythrocyte transfusion strategy (hemoglobin threshold between 7.5 and 8 g/dL) is recommended for CT, potentially tailored to tissue perfusion or oxygenation values [13,24].…”

Section: Figurementioning

confidence: 99%

Anticoagulation and Antiplatelet Regimen in Cardiac Transplant. Clinical Characteristics, Outcomes, and Blood Product Transfusion

Groba Marco,

Saavedra Santana,

Gonzalez del Castillo

et al. 2024

Clinical Transplantation

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BackgroundWe aimed to evaluate the characteristics, clinical outcomes, and blood product transfusion (BPT) rates of patients undergoing cardiac transplant (CT) while receiving uninterrupted anticoagulation and antiplatelet therapy.MethodsA retrospective, single‐center, and observational study of adult patients who underwent CT was performed. Patients were classified into four groups: (1) patients without anticoagulation or antiplatelet therapy (control), (2) patients on antiplatelet therapy (AP), (3) patients on vitamin K antagonists (AVKs), and (4) patients on dabigatran (dabigatran). The primary endpoints were reoperation due to bleeding and perioperative BPT rates (packed red blood cells (PRBC), fresh frozen plasma, platelets). Secondary outcomes assessed included morbidity and mortality‐related events.ResultsOf the 55 patients included, 6 (11%) received no therapy (control), 8 (15%) received antiplatelet therapy, 15 (27%) were on AVKs, and 26 (47%) were on dabigatran. There were no significant differences in the need for reoperation or other secondary morbidity‐associated events. During surgery patients on dabigatran showed lower transfusion rates of PRBC (control 100%, AP 100%, AVKs 73%, dabigatran 50%, p = 0.011) and platelets (control 100%, AP 100%, AVKs 100%, dabigatran 69%, p = 0.019). The total intraoperative number of BPT was also the lowest in the dabigatran group (control 5.5 units, AP 5 units, AVKs 6 units, dabigatran 3 units; p = 0.038); receiving significantly less PRBC (control 2.5 units, AP 3 units, AVKs 2 units, dabigatran 0.5 units; p = 0.011). A Poisson multivariate analysis showed that only treatment on dabigatran reduces PRBC requirements during surgery, with an expected reduction of 64.5% (95% CI: 32.4%–81.4%).ConclusionsIn patients listed for CT requiring anticoagulation due to nonvalvular atrial fibrillation, the use of dabigatran and its reversal with idarucizumab significantly reduces intraoperative BPT demand.

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Perioperative red blood cell transfusion and mortality following heart transplantation: A retrospective nationwide population‐based study between 2007 and 2016 in Korea

Cited by 16 publications

References 36 publications

Initial Postoperative Hemoglobin Values Are Independently Associated With One-Year Mortality in Patients Undergoing Double-Lung Transplantation Requiring Intraoperative Transfusion

Initial Postoperative Hemoglobin Values Are Independently Associated With One-Year Mortality in Patients Undergoing Double-Lung Transplantation Requiring Intraoperative Transfusion

Increased severe primary graft dysfunction in left ventricular assist device patients following united network for organ sharing allocation changes

Anticoagulation and Antiplatelet Regimen in Cardiac Transplant. Clinical Characteristics, Outcomes, and Blood Product Transfusion

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