No funding was received for the development of this article, and none of the authors have reported a conflict of interest.
Transfusion of older red blood cells is associated with decreased graft survival after orthotopic liver transplantation
Article first published online: 14 SEP 2013
© 2013 American Association for the Study of Liver Diseases
Volume 19, Issue 11, pages 1181–1188, November 2013
How to Cite
Cywinski, J. B., You, J., Argalious, M., Irefin, S., Parker, B. M., Fung, J. J. and Koch, C. G. (2013), Transfusion of older red blood cells is associated with decreased graft survival after orthotopic liver transplantation. Liver Transpl, 19: 1181–1188. doi: 10.1002/lt.23695
- Issue published online: 28 OCT 2013
- Article first published online: 14 SEP 2013
- Accepted manuscript online: 27 JUN 2013 11:50AM EST
- Manuscript Accepted: 12 JUN 2013
- Manuscript Received: 28 AUG 2012
Investigations have demonstrated conflicting results regarding the influence of the red blood cell (RBC) storage duration on outcomes. We evaluated whether graft failure or mortality after orthotopic liver transplantation (OLT) increased when recipients were transfused with older RBCs. This study included 637 patients who underwent OLT between January 2001 and June 2011. Baseline and perioperative data were obtained from our blood bank, the Unified Transplant Center database, and the United Network for Organ Sharing database. Recipients whose transfused RBCs were all stored for ≤15 days were grouped in a younger group, and recipients who were transfused with RBCs stored for >15 days were placed in an older group. The relationship between graft survival/mortality and the age of intraoperatively transfused RBCs was studied by Kaplan-Meier estimation with a log-rank test and multivariate Cox proportional hazards regression. Three hundred thirty-four patients and 303 patients were grouped in the younger and the older RBC groups, respectively, on the basis of the ages of intraoperatively transfused RBCs. Kaplan-Meier estimates of graft survival/mortality as a function of the posttransplant time were significantly different: the older group experienced the outcome sooner than the younger group [P = 0.02 (log-rank test)]. After covariate adjustments, the risk of graft failure/mortality was significantly different at any given time after transplantation between patients receiving intraoperative transfusions of older RBC units and patients receiving intraoperative transfusions of younger RBC units (hazard ratio = 1.65, 95% confidence interval = 1.18-2.31). In conclusion, patients who received intraoperative transfusions of RBCs with longer storage times had an increased risk of adverse outcomes. Liver Transpl 19:1181–1188, 2013. © 2013 AASLD.