Transfusion with packed red blood cells while awaiting lung transplantation is associated with reduced survival after lung transplantation

Abstract

Blood transfusion while on the LTx wait list was associated with diminished patient survival after transplantation.

Perioperative Management of Bleeding and Transfusion for Lung Transplantation

“…Pretransplant RBC transfusion is also associated with both PGD as well as greater mortality. 19 A retrospective, propensity-matched US cohort study by Hayes et al 19 identified pretransplant transfusion as a risk factor for all-cause mortality at 1 year. The incidence of pretransplant transfusion was 34%, which was associated with an adjusted hazards ratio of 1.18.…”

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

“…exceeding 5 units and potentially when less than 2 units are given (Figure 2). While preoperative transfusion of PRBC in patients awaiting lung transplantation had been connected to reduced survival after lung transplantation by other investigators before, 27 intraoperative allogenic blood transfusion was found to have no undesirable impact on outcome among 310 lung transplantation recipients. 28,29 The risk for developing transfusion reactions might even be attenuated in this population, which could be due to suppression of immunological reactions by transfusion of irradiated PRBC and perioperative immunosuppression.…”

Blood product transfusion and lung transplant outcomes: A systematic review

“…Of course, the need for transfusion was again just one of many high-risk variables in this cohort of patients. 10 That said, subsequent propensity matching was performed to control for these disparities and survival remained worse in the transfused cohort.…”

“…Thirteen studies directly addressed the question of transfusion and lung transplant (Table 1). [6][7][8][9][10][11][12][13][14][15][16][17][18] Eleven of the 13 studies were single center and retrospective. Four studies reviewed center-specific interventions for reducing transfusion requirements specific to lung transplant patients.…”