Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Schrem, H; Klußmann, A; Focken, M; Emmanouilidis, N; Oldhafer, F; Klempnauer, J; Kaltenborn, A.
Post-Operative Hemorrhage After Liver Transplantation: Risk Factors and Long-Term Outcome.
Ann Transplant. 2016; 21(6): 46-55.
Doi: 10.12659/AOT.895605
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- Leading authors Med Uni Graz
- Schrem Harald Heinrich
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- Abstract:
- Increasing scarcity of donated liver grafts clearly demonstrates the desperate need for ongoing outcome analysis to improve patient and graft survival after liver transplantation. Coagulation is often severely deteriorated in patients suffering from liver disease, thus leading to bleeding complications after liver transplantation. We included 770 liver transplantations in this single-center retrospective analysis to identify independent risk factors for post-operative hemorrhage. The relevance of bleeding complications was assessed with special regards to coagulation-related variables. Multivariate regression analyses allowed weighing of different risk factors. Post-operative hemorrhage leading to revision surgery was observed in 19.9% (n=153 cases) of cases and was revealed as an independent risk factor for mortality (p=0.014; HR: 1.457; 95%-CI: 1.081-1.964). Risk-adjusted multivariate regression analysis compiling all pre- and intra-operative donor and recipient variables revealed that only the number of transfused packed red blood cells (p<0.001; OR: 1.072; 95%-CI: 1.036-1.110), hepatitis B virus-related liver disease (p=0.019; OR: 0.082; 95%-CI: 0.010-0.666), model of end-stage liver disease-era (p=0.020; OR: 1.016; 95%-CI: 1.002-1.029), partial thromboplastin time at transplantation (p=0.021; OR: 1.016; 95%-CI: 1.002-1.029), and donor intensive care unit stay in days (p=0.009; OR: 1.009; 95%-CI: 1.002-1.016) were significantly associated with the occurrence of post-operative hemorrhage. Post-operative hemorrhage relevantly contributed post-transplant mortality. Avoidance of excessive packed red blood cell use during transplantation and short donor-intensive care unit stay lead to a decreased rate of bleeding complications. Coagulations state at transplantation is also relevant for favorable outcome.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Aged -
- Biomarkers - blood
- Female -
- Follow-Up Studies -
- Graft Survival -
- Humans -
- Liver Transplantation -
- Male -
- Middle Aged -
- Multivariate Analysis -
- Outcome Assessment (Health Care) -
- Platelet Count -
- Postoperative Hemorrhage - blood
- Postoperative Hemorrhage - etiology
- Postoperative Hemorrhage - mortality
- Prothrombin - metabolism
- Retrospective Studies -
- Risk Factors -
- Young Adult -
- Find related publications in this database (Keywords)
- Blood Platelets
- Hemorrhage
- Liver Transplantation
- Platelet Count
- Thrombocytopenia