Pena Joseph J, Bottiger Brandi A, Miltiades Andrea N
Columbia University Medical Center, New York, NY, USA.
Duke University Medical Center, Durham, NC, USA.
Semin Cardiothorac Vasc Anesth. 2020 Mar;24(1):74-83. doi: 10.1177/1089253219869030. Epub 2019 Aug 14.
Perioperative allogeneic blood product transfusion is common in lung transplantation and has various implications on the short- and long-term outcomes of lung recipients. This review summarizes the effect of transfusion on outcomes including primary graft dysfunction, chronic lung allograft dysfunction, and all-cause mortality. We outline known risk factors for increased transfusion requirement in lung transplantation and present current evidence regarding the effect of hemostatic agents including antifibrinolytics, recombinant factor VII, and prothrombin complex concentrates. Finally, we highlight the roles of point-of-care coagulation testing and goal-directed transfusion strategies in reducing transfusion requirements in lung transplantation.
围手术期异体血制品输注在肺移植中很常见，并且对肺移植受者的短期和长期预后有多种影响。本综述总结了输血对包括原发性移植肺功能障碍、慢性移植肺功能障碍和全因死亡率等预后的影响。我们概述了肺移植中输血需求增加的已知危险因素，并介绍了关于止血剂（包括抗纤溶药物、重组凝血因子VII和凝血酶原复合物浓缩剂）作用的现有证据。最后，我们强调了床旁凝血检测和目标导向输血策略在减少肺移植输血需求方面的作用。
