Tao Lv1,2, Xi Xu1,2, Jiulin Song1,2, Yifei Tan1,2, Li Jiang1,2, Jian Yang1,2, Diao He1,2, Lingxiang Kong1,2, Weiyi Zhang3, Panyu Chen4, Qiwen Xiang4, Tao Zhu3, Hong Wu1, Tianfu Wen1,2, Jiayin Yang1,2. 1. Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, China. 2. Laboratory of Liver Transplantation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital of Sichuan University, Chengdu, China. 3. Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China. 4. Operating Room of West China Hospital, West China School of Nursing, Sichuan University, Chengdu, China.
Abstract
BACKGROUND: Increased risks have been found for patients undergoing liver transplantation due to the blood supply shortage following the ongoing coronavirus disease 2019 (COVID-19) pandemic. Hence, exploring a method to alleviate this dilemma is urgent. This phase I, nonrandomized, prospective trial aimed to evaluate the safety and feasibility of using donor-specific red blood cell transfusion (DRBCT) as an urgent measurement to alleviate the blood supply shortage in deceased donor liver transplantation (DDLT). METHODS: The outcomes of 26 patients who received DRBCT and 37 patients in the control group who only received 3rd party packed red blood cells (pRBCs) transfusion between May 2020 and January 2021 were compared. RESULTS: Patients receiving DRBCT did not develop transfusion-related complications, and the incidence of postoperative infection was similar to that in the control group (23.1% vs. 18.9%, P=0.688). Because the patients received the red blood cells from organ donors, the median volume of intraoperative allogeneic red blood cell transfusion from blood bank was 4.0 U (IQR 1.1-8.0 U) in the DRBCT group, which is significantly lower than that (7.5 U, IQR 4.0-10.0 U) in the control group (P=0.018). The peak aspartate aminotransferase (AST) level was significantly lower in the DRBCT group than in the control group (P=0.008) and so were the AST levels in the first two days after the operation (P=0.006 and P=0.033). CONCLUSIONS: DRBCT is a safe and effective procedure to lower the need for blood supply and is associated with a reduction in AST levels after transplantation. DRBCT is beneficial to patients receiving life-saving transplantation without sufficient blood supply during the COVID-19 pandemic. 2021 Hepatobiliary Surgery and Nutrition. All rights reserved.
BACKGROUND: Increased risks have been found for patients undergoing liver transplantation due to the blood supply shortage following the ongoing coronavirus disease 2019 (COVID-19) pandemic. Hence, exploring a method to alleviate this dilemma is urgent. This phase I, nonrandomized, prospective trial aimed to evaluate the safety and feasibility of using donor-specific red blood cell transfusion (DRBCT) as an urgent measurement to alleviate the blood supply shortage in deceased donor liver transplantation (DDLT). METHODS: The outcomes of 26 patients who received DRBCT and 37 patients in the control group who only received 3rd party packed red blood cells (pRBCs) transfusion between May 2020 and January 2021 were compared. RESULTS: Patients receiving DRBCT did not develop transfusion-related complications, and the incidence of postoperative infection was similar to that in the control group (23.1% vs. 18.9%, P=0.688). Because the patients received the red blood cells from organ donors, the median volume of intraoperative allogeneic red blood cell transfusion from blood bank was 4.0 U (IQR 1.1-8.0 U) in the DRBCT group, which is significantly lower than that (7.5 U, IQR 4.0-10.0 U) in the control group (P=0.018). The peak aspartate aminotransferase (AST) level was significantly lower in the DRBCT group than in the control group (P=0.008) and so were the AST levels in the first two days after the operation (P=0.006 and P=0.033). CONCLUSIONS: DRBCT is a safe and effective procedure to lower the need for blood supply and is associated with a reduction in AST levels after transplantation. DRBCT is beneficial to patients receiving life-saving transplantation without sufficient blood supply during the COVID-19 pandemic. 2021 Hepatobiliary Surgery and Nutrition. All rights reserved.
Authors: Hans-Peter Marti; Jana Henschkowski; Gunter Laux; Bruno Vogt; Christian Seiler; Gerhard Opelz; Felix J Frey Journal: Transpl Int Date: 2006-01 Impact factor: 3.782
Authors: Ruchika Goel; Molly R Petersen; Eshan U Patel; Zoe Packman; Evan M Bloch; Eric A Gehrie; Parvez M Lokhandwala; Paul M Ness; Beth Shaz; Louis M Katz; Steven M Frank; Aaron A R Tobian Journal: Transfusion Date: 2020-08-31 Impact factor: 3.157