Analysis of the impact of intraoperative RhE antigen-matched transfusion on early prognosis in liver transplant patients
10.13303/j.cjbt.issn.1004-549x.2026.01.006
- VernacularTitle:肝移植术中RhE抗原匹配输血对患者早期预后的影响分析
- Author:
Xiaochao YU
1
;
Xinyuan GAO
1
;
Fan HAI
2
;
Chao YANG
2
;
Xingyu HOU
2
;
Yaping XING
2
;
Hongqiang GAO
3
;
Hongwei ZHANG
4
;
Gang SU
5
;
Ronghua XU
2
Author Information
1. Department of Blood Transfusion, Kunming Medical University Affiliated Ganmei Hospital, Kunming 650000, China
2. Department of Blood Transfusion, The First Hospital of Kunming, Kunming 650000, China
3. Department of Hepatobiliary Surgery, The First Hospital of Kunming,, Kunming 650000, China
4. Department of Laboratory Medicine, The First Hospital of Kunming, Kunming 650000, China
5. Department of Anesthesiology, The First Hospital of Kunming, Kunming 650000, China
- Publication Type:Journal Article
- Keywords:
Rh blood group;
E antigen;
blood transfusion;
liver function
- From:
Chinese Journal of Blood Transfusion
2026;39(1):44-50
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the impact of RhE antigen-matched transfusion during liver transplantation on early postoperative recovery and complications. Methods: In this retrospective cohort study, ninety-five patients undergoing liver transplantation at Kunming First People's Hospital between January 2022 and July 2025 were enrolled. Patients were divided into two groups: Group 1 (RhE-mismatched transfusion, n=57) and Group 2 (RhE-matched transfusion, n=38). The baseline data, complete blood counts, hepatic and renal function, coagulation parameters, and complication rates between the two groups were compared at postoperative days 1, 3, 5, 7, and 10. Survival analysis was performed using the Kaplan-Meier method. Results: The baseline characteristics were well-balanced and comparable between the two groups (all P>0.05). The early postoperative mortality rate in the mismatched group (31.58%, 18/57) was significantly higher than that in the matched group (10.53%, 4/38) (P=0.017). The incidence of postoperative hepatic encephalopathy was significantly higher in the mismatched group (50.88%, 29/57) than in the matched group (10.53%, 4/38) (P<0.001). The incidence of postoperative haemorrhage in the mismatched group (24.56%, 14/57) was higher than that in the matched group (5.26%, 2/38), with a statistically significant difference (P=0.014). The incidence of perioperative infection in the mismatched group (28.07%, 16/57) was higher than that in the matched group (10.53%, 4/38), with a statistically significant difference (P=0.04). Corresponding odds ratios (OR) and 95% confidence intervals indicated a lower risk of these adverse events in the matched group. On postoperative day 1, the change in activated partial thromboplastin time (-1.6, 20.5) in the mismatched group was greater than in the matched group (-0.2, 5.5). The change in international normalised ratio (-0.56, 1.22) in the mismatched group was greater than in the matched group (-0.18, 0.32), while the change in albumin (-4.0, 4.8) was smaller in the mismatched group than in the matched group (-2.5, 8.8). On postoperative day 5, the change in albumin (-0.41±7.83) in the mismatched group was smaller than in the matched group (2.68±4.53). At postoperative day 7, the change in albumin in the mismatched group (-0.61±7.38) was smaller than that in the matched group (2.51±5.85), while the change in D-dimer in the mismatched group (0.73, 7.4) was greater than that in the matched group (-1.6, 4.3). On postoperative day 10, the mismatched group exhibited significantly higher fibrinogen levels (-1.21, 1.78) than the matched group (-0.49, 0.97), and significantly longer prothrombin times (-11.3, -2.7) than the matched group (-6.2, -0.8) (all P<0.05). The matched group exhibited a mean overall survival (OS) of 32.803 months (95% CI:29.171-36.436 months), significantly exceeding the mismatched group's 28.996 months (95% CI:24.202-33.790 months). The log-rank test yielded statistically significant results (χ
=4.307, P=0.038). Conclusion: Implementing RhE blood group-matched transfusion during liver transplantation may help reduce early postoperative mortality and the incidence of major complication rates, promote faster recovery of coagulation and liver function, and thereby improve short-term patient outcomes.
