Analysis of risk factors and clinical prognosis of massive blood transfusion during perioperative period of lung transplantation
10.3969/j.issn.1674-7445.2021.02.011
- VernacularTitle:肺移植围手术期大量输血的危险因素及其预后分析
- Author:
Huanshun WEN
1
;
Yang HAO
;
Jingyu CHEN
;
Chaoyang LIANG
Author Information
1. Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing 100029, China
- Publication Type:Research Article
- Keywords:
Lung transplantation;
Blood transfusion;
End-stage lung disease;
Primary graft dysfunction;
Intrathoracic adhesion;
Extracorporeal membrane oxygenation;
Anticoagulant therapy;
Body mass index;
Operation time
- From:
Organ Transplantation
2021;12(2):203-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors and clinical prognosis of massive blood transfusion during the perioperative period of lung transplantation. Methods Clinical data of 159 lung transplant recipients were retrospectively analyzed. According to the quantity of perioperative blood transfusion, all recipients were divided into the massive blood transfusion group (n=20) and non-massive blood transfusion group (n=139). Clinical data of lung transplant recipients were statistically compared between two groups. The risk factors of perioperative massive blood transfusion were analyzed. Clinical prognosis of the recipients was observed in two groups. Results There were significant differences between the two groups in preoperative data including anticoagulant therapy, hemoglobin content, the number of recipents with idiopathic pulmonary fibrosis or idiopathic pulmonary hypertension, and intraoperative data including the number of recipents presenting with intraoperative intrathoracic adhesion, operation time and the amount of various component transfusion(all P < 0.05). Preoperative anticoagulant therapy, incidence of intraoperative intrathoracic adhesion, use of extracorporeal membrane oxygenation (ECMO) and long operation time were the risk factors of massive blood transfusion during perioperative period of lung transplantation(all P < 0.05). In the massive blood transfusion group, the incidence rate of grade Ⅲ primary graft dysfunction (PGD) and the fatality within postoperative 30 d were higher compared with those in the non-massive blood transfusion group(both P < 0.01). Low body mass index (BMI) and massive blood transfusion were the risk factors for death within postoperative 30 d(P=0.048、P < 0.001). The 1-year survival rate in the massive blood transfusion group was lower than that in the non-massive blood transfusion group(P < 0.001). Conclusions Preoperative anticoagulant therapy, incidence of intraoperative intrathoracic adhesion, use of ECMO and long operation time are the risk factors for massive blood transfusion during perioperative period of lung transplantation. Massive blood transfusion negatively affects the clinical prognosis of the recipients undergoing lung transplantation.
