Increased bleeding tendency in liver transplantation for alcoholic liver disease
10.52604/alt.25.0007
- Author:
Mun Chae CHOI
;
Eun-Ki MIN
;
Deok-Gie KIM
;
Jae Geun LEE
;
Dae Hoon HAN
;
Gi Hong CHOI
;
Jin Sub CHOI
;
Myoung Soo KIM
;
Sinyoung KIM
;
Dong Jin JOO
- Publication Type:Original Article
- From:
Annals of Liver Transplantation
2025;5(2):134-141
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Alcoholic liver disease (ALD) includes a wide clinical spectrum from acute alcoholic hepatitis to severe cirrhosis and/or hepatocellular carcinoma. Until now, there has been no report revealing the bleeding tendency of ALD compared to other diseases in liver transplantation (LT). Thus, we analyzed blood loss and transfusion amounts during operation according to the etiologies of liver disease and model for end-stage liver disease (MELD) score.
Methods:Out of 874 recipients who underwent LT, a total of 146 patients were excluded by our exclusion criteria. We compared 728 recipients’ baseline characteristics, operation time, blood loss, and transfusion amounts between ALD and nonALD according to MELD score.
Results:The number of patients in the ALD group was 130 (17.9%), and 598 (82.1%) in the non-ALD group. The ALD group showed younger age, higher MELD score, and a higher proportion of deceased donor LT than the non-ALD group. Intraoperative blood loss and transfusions of red blood cells (RBCs), fresh frozen plasma, and platelets were significantly higher in the ALD group. When stratified by MELD score (cut-off: 20), ALD patients in both high and low MELD subgroups demonstrated greater blood loss and RBC transfusion requirements, even when international normalized ratio and platelet counts were similar. In multivariate logistic regression analysis, ALD was a significant risk factor for massive transfusion (odds ratio 1.813, 95% confidence interval 1.158–2.840, p=0.009).
Conclusion:The ALD group showed increased bleeding tendency than the non-ALD group during LT, irrespective of MELD score. This suggests that transplant surgeons should anticipate greater blood loss and ensure adequate transfusion resources during LT for ALD patients.
