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ISSN 3122-3893 (Electronic)

2026, Number 1

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Rev Mex Traspl 2026; 15 (1)

Association of graft dysfunction in patients undergoing liver transplantation and massive transfusion admitted to the Intensive Care Unit of the ''La Raza'' National Medical Center

Vázquez-Melchor M, Canedo-Castillo NA

Language: Spanish
References: 17
Page: 8-15
PDF size: 955.67 Kb.


ABSTRACT

Introduction: liver transplantation is the treatment of choice in patients with acute liver failure and end-stage liver disease with coagulation factor abnormalities and a high risk of bleeding during the immediate postoperative period; massive transfusion remains an effective therapy to improve blood volume and correct coagulopathy, but its association with graft dysfunction and mortality has not been studied. Objective: to analyze the association of graft dysfunction in patients undergoing liver transplantation and massive transfusion admitted to the Intensive Care Unit of the National Medical Center "La Raza". Material and methods: observational, retrospective, single-center, descriptive and analytical study; with a randomized probabilistic sample that included 78 orthotopic liver transplant patients and massive transfusion, to analyze their association with a bivariate and χ2 analysis. Results: of the total number of patients, 40 were divided into two groups: 40 with graft dysfunction and 38 without graft dysfunction. The median age was 50 years [IQR 27-69], 50% (n = 39) were women, 18% (n = 14) underwent massive transfusion, 51.3% (n = 40) had some degree of graft dysfunction, 61% (n = 60) experienced delayed graft function, and mortality was 10.3% (n = 8) in the group with graft dysfunction, a significant difference (p = 0.001). Conclusions: there is no association of graft dysfunction in patients with massive transfusion in patients undergoing liver transplantation and other factors should be studied to reduce the risk of graft dysfunction and ensure patient survival.


REFERENCES

  1. Chen S, Liu LP, Wang YJ, Zhou XH, Dong H, Chen ZW et al. Advancing prediction of risk of intraoperative massive blood transfusion in liver transplantation with machine learning models. A multicenter retrospective study. Front Neuroinform. 2022; 16: 893452.

  2. Gobierno de México, Centro Nacional de Trasplantes. Estadísticas sobre donación y trasplante. Disponible en: https://www.gob.mx/cenatra/documentos/estadisticas-50060

  3. European Association for the Study of the Liver. EASL Clinical Practice Guidelines on liver transplantation. J Hepatol. 2024; 81 (6): 1040-1086.

  4. Zakeri N, Tsochatzis EA. Bleeding risk with invasive procedures in patients with cirrhosis and coagulopathy. Curr Gastroenterol Rep. 2017; 19 (9): 45.

  5. Northup PG, Garcia-Pagan JC, Garcia-Tsao G, Intagliata NM, Superina RA, Roberts LN et al. Vascular liver disorders, portal vein thrombosis, and procedural bleeding in patients with liver disease: 2020 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021; 73 (1): 366-413.

  6. Danforth D, Gabriel RA, Clark AI, Newhouse B, Khoche S, Vig S et al. Preoperative risk factors for massive transfusion, prolonged ventilation requirements, and mortality in patients undergoing liver transplantation. Korean J Anesthesiol. 2020; 73 (1): 30-35.

  7. Lin VS, Sun E, Yau S, et al. Definitions of massive transfusion in adults with critical bleeding: a systematic review. Crit Care. 2023; 27 (1): 265.

  8. Morkane CM, Sapisochin G, Mukhtar AM, Reyntjens KMEM, Wagener G, Spiro M et al. Perioperative fluid management and outcomes in adult deceased donor liver transplantation - A systematic review of the literature and expert panel recommendations. Clin Transplant. 2022; 36 (10): e14651.

  9. Mittal S, Bhardwaj M, Shekhrajka P, et al. An overview of unresolved issues in the perioperative management of liver transplant patients. Korean J Transplant. 2023; 37 (4): 221-228.

  10. Hartmann M, Szalai C, Saner FH. Hemostasis in liver transplantation: Pathophysiology, monitoring, and treatment. World J Gastroenterol. 2016; 22 (4): 1541-1550.

  11. Gong N, Jia C, Huang H, Liu J, Huang X, Wan Q. Predictors of mortality during initial liver transplant hospitalization and investigation of causes of death. Ann Transplant. 2020; 25: e926020.

  12. Zhong F, Cheng XS, He K, Sun SB, Zhou J, Chen HM. Treatment outcomes of spontaneous rupture of hepatocellular carcinoma with hemorrhagic shock: a multicenter study. Springerplus. 2016; 5 (1): 1101.

  13. Schumacher C, Eismann H, Sieg L, Friedrich L, Scheinichen D, Vondran FWR et al. Use of rotational thromboelastometry in liver transplantation is associated with reduced transfusion requirements. Exp Clin Transplant. 2019; 17 (2): 222-230.

  14. Massicotte L, Carrier FM, Denault AY, Karakiewicz P, Hevesi Z, McCormack M et al. Development of a predictive model for blood transfusions and bleeding during liver transplantation: an observational cohort study. J Cardiothorac Vasc Anesth. 2018; 32 (4): 1722-1730.

  15. Yuan H, Tuttle-Newhall JE, Chawa V, Schnitzler MA, Xiao H, Axelrod D et al. Prognostic impact of mechanical ventilation after liver transplantation: a national database study. Am J Surg. 2014; 208 (4): 582-590.

  16. Hudcova J, Qasmi ST, Ruthazer R, Waqas A, Haider SB, Schumann R. Early allograft dysfunction following liver transplant: impact of obesity, diabetes, and red blood cell transfusion. Transplant Proc. 2021; 53 (1): 119-123.

  17. Gao Q, Cai JZ, Dong H. A review of the risk factors and approaches to prevention of post-reperfusion syndrome during liver transplantation. Organogenesis. 2024; 20 (1): 2386730




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