The impact of restrictive blood transfusion on the safety of patients with esophageal varices after endoscopic variceal ligation

Abstract

Background: To study the effect of restrictive blood transfusion on the safety of early rebleeding after endoscopic variceal ligation(EVL) in patients with liver cirrhosis. Methods:The patients with cirrhosis and esophageal varices who underwent endoscopic variceal ligation at the Affiliated Hospital of North Sichuan Medical College from September 2021 to March 2023 were collected. The clinical data such as serum albumin level, hemoglobin level, liver function classification and the incidence of early rebleeding were recorded. The patients were divided into restrictive red blood cell transfusion group and non transfusion group according to whether there was red blood cell transfusion during hospitalization. The influence of restrictive transfusion and non transfusion group on the postoperative safety of endoscopic variceal ligation was observed. Results:A total of 246 cirrhotic patients were included in the analysis. There were significant differences in hemoglobin level, liver function classification, early rebleeding rate, hospitalization days, and hospitalization expenses between the restrictive transfusion and the non transfusion groups. The early rebleeding rate was significantly different between the groups with different hemoglobin levels after operation. Multivariate logistic analysis showed that postoperative hemoglobin level(OR=0.964, 95%CI: 0.956–0.971; P<0.001) and preoperative albumin level(OR=0.910, 95%CI: 0.892–0.929; P<0.001) were independent influencing factors of early rebleeding. Conclusions:The higher the hemoglobin level of cirrhotic patients with esophageal varices after endoscopic variceal ligation, the lower the incidence of early rebleeding, and restrictive blood transfusion appeared to increase the risk of early rebleeding, which needs be further confirmed in future research.