Liu Guanghua, Lei Ping, Liao Chushu, Huang Kangle, Li Lingqian, Cao Youde, Chen Jie
Department of Blood Transfusion, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China.
Laboratory of Hematology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China.
Transfus Med. 2023 Feb;33(1):61-67. doi: 10.1111/tme.12937. Epub 2022 Nov 9.
Haemorrhage and coagulation disorders are common complications in cirrhotic patients, which cause blood products transfusion, and mounting evidence suggested that red blood cells (RBCs) were associated with pathologic thrombosis and RBC transfusion increased the risk of venous thromboembolism (VTE).
The aim of the study was to investigate the association of RBC transfusion with splanchnic vein thrombosis (SVT) in cirrhotic patients.
MATERIALS & METHODS: We retrospectively reviewed patients with cirrhosis admitted in the Hunan Provincial People's Hospital between January 2010 and September 2020. Demographic data, the development of SVT, blood transfusion product type and RBC transfusion dose were collected. Multivariate logistic regression analyses and propensity matching analysis (PSM) were performed to identify the association between RBC transfusion and development of SVT.
A total of 4479 patients with cirrhosis were enrolled in the study. SVT occurred in 48 (12.4%) cirrhotic patients in RBC transfusion group, and 233 (5.7%) cirrhotic patients in non-RBC transfusion group. RBC transfusion was significantly associated with an increased risk of SVT (unadjusted odds ratio [OR] 2.345, 95% confidence interval [CI] 1.686-3.262, p < 0.001). Notably, this association remained robust after PSM, and the volume of RBC transfusion was associated with SVT in a dose-dependent manner.
This study suggested that RBC transfusion was associated with an increased risk of SVT in cirrhotic patients. High quality clinical study will be needed to further validate the association between RBC transfusion and SVT.
出血和凝血障碍是肝硬化患者常见的并发症，会导致血液制品的输注，越来越多的证据表明红细胞（RBC）与病理性血栓形成有关，且红细胞输注会增加静脉血栓栓塞（VTE）的风险。
本研究旨在探讨肝硬化患者红细胞输注与脾静脉血栓形成（SVT）之间的关联。
我们回顾性分析了2010年1月至2020年9月在湖南省人民医院住院的肝硬化患者。收集患者的人口统计学数据、SVT的发生情况、输血制品类型和红细胞输注剂量。采用多因素逻辑回归分析和倾向匹配分析（PSM）来确定红细胞输注与SVT发生之间的关联。
本研究共纳入4479例肝硬化患者。红细胞输注组有48例（12.4%）肝硬化患者发生SVT，非红细胞输注组有233例（5.7%）肝硬化患者发生SVT。红细胞输注与SVT风险增加显著相关（未调整优势比[OR]为2.345，95%置信区间[CI]为1.686 - 3.262，p < 0.001）。值得注意的是，PSM后这种关联仍然显著，且红细胞输注量与SVT呈剂量依赖性相关。
本研究表明，红细胞输注与肝硬化患者SVT风险增加有关。需要高质量的临床研究来进一步验证红细胞输注与SVT之间的关联。
