与供肝切除术中输血相关的因素：来自一个大型单中心的 2344 例供者的结果。

Factors associated with blood transfusion in donor hepatectomy: results from 2344 donors at a large single center.

机构信息

1 Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 2 Department of Occupational and Environmental Health, Graduate School of Public Health, Seoul National University, Seoul, Korea. 3 Address correspondence to: Young-Kug Kim, M.D., Ph.D., Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Republic of Korea.

出版信息

Transplantation. 2013 Dec 15;96(11):1000-7. doi: 10.1097/TP.0b013e3182a41937.

DOI:10.1097/TP.0b013e3182a41937

PMID:23985722

Abstract

BACKGROUND

The safety of healthy living donors undergoing hepatic resection for living-donor liver transplantation is of paramount concern. Although blood transfusions have been associated with morbidity and mortality after hepatectomy, there is limited information about the risk factors associated with blood transfusion in living liver donors.

METHODS

We retrospectively analyzed 2344 donors who underwent a hepatectomy for living-donor liver transplantation. Logistic regression analysis was performed to determine blood transfusion predictors in living-donor hepatectomy.

RESULTS

Of these donors, 48 (2.0%) and 97 (4.1%) were transfused with packed red blood cell (PRBC) and fresh-frozen plasma (FFP), respectively. The amount of PRBC and FFP administered to donors transfused with blood products were 1.9±0.8 and 3.7±2.5 units, respectively. In multivariate logistic regression analysis, a low preoperative hemoglobin level was found to be an independent predictor of PRBC transfusion in donor hepatectomy (odds ratio=0.585; 95% confidence interval=0.451-0.758; P<0.001). A high graft-to-donor weight ratio predicted an FFP transfusion in donor hepatectomy (odds ratio=2.997; 95% confidence interval=1.226-7.327; P=0.016).

CONCLUSIONS

These results indicate that, in donor hepatectomy, the preoperative hemoglobin value and graft-to-donor weight ratio can provide useful information on the probability of PRBC and FFP transfusion, respectively.

摘要

背景

接受肝切除术的健康活体供者进行活体肝移植的安全性至关重要。尽管输血与肝切除术后的发病率和死亡率有关，但关于活体肝供者输血相关风险因素的信息有限。

方法

我们回顾性分析了 2344 名接受活体肝移植肝切除术的供者。采用 logistic 回归分析确定活体肝切除术中输血的预测因素。

结果

在这些供者中，分别有 48 名（2.0%）和 97 名（4.1%）接受了红细胞悬液（PRBC）和新鲜冷冻血浆（FFP）输血。输注血液制品的供者输注的 PRBC 和 FFP 量分别为 1.9±0.8 和 3.7±2.5 单位。多变量 logistic 回归分析显示，术前低血红蛋白水平是供者肝切除术中 PRBC 输血的独立预测因素（比值比=0.585；95%置信区间=0.451-0.758；P<0.001）。高移植物与供者体重比预测供者肝切除术中 FFP 输血（比值比=2.997；95%置信区间=1.226-7.327；P=0.016）。