Article ; Online: The Impact of Pre-Heart Transplantation Blood Transfusion Varies Based on Recipient MELD-XI Score.
ASAIO journal (American Society for Artificial Internal Organs : 1992)
2024
Abstract: ... for end-stage liver disease excluding international normalized ratio (MELD-XI) score of 9.4, and propensity score matched ... showed transfusion recipients, MELD-XI ≥9.4, were more likely to experience post-heart transplantation ... With MELD-XI <9.4, there was slight survival detriment among transfusion recipients on univariable analysis ...
Abstract | Prior studies reveal adverse effects of transfusion on cardiac surgery, but little is known of transfusion impact on heart transplantation. First-time, single-organ adult heart transplant recipients between January 1, 2010, and December 31, 2020, were included, stratified above or below a model for end-stage liver disease excluding international normalized ratio (MELD-XI) score of 9.4, and propensity score matched to their nearest neighbor. A 90 day landmark analysis within each cohort was also performed. Unadjusted analysis showed transfusion recipients, MELD-XI ≥9.4, were more likely to experience post-heart transplantation mortality (Hazard Ratio (HR), 1.352 [95% Confidence Interval (CI), 1.239-1.477], p < 0.001), persisting after adjustment for potential confounders (adjusted HR, 1.211 [95% CI, 1.100-1.335], p < 0.001) and after propensity-score matching (HR, 1.174 [95% CI, 1.045-1.319], p = 0.007). Post-transplant length of stay was longer (25.9 vs. 23.2 days, p < 0.001). Post-transplant dialysis was more common (18.7 vs. 15.9%, p = 0.009). There was no survival difference on 90 day landmarked analysis (p = 0.108). With MELD-XI <9.4, there was slight survival detriment among transfusion recipients on univariable analysis (HR, 1.111 [95% CI, 1.001-1.234], p = 0.049) but not on multivariable analysis (adjusted HR, 1.061 [95% CI, 0.952-1.181], p = 0.285). There was similar survival after propensity-score matching (HR, 1.032 [95% CI, 0.903-1.180], p = 0.642) and on landmark analysis (p = 0.581). Ultimately, transfusion was associated with worse post-heart transplantation outcomes among recipients with a MELD-XI ≥9.4. |
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Language | English |
Publishing date | 2024-03-06 |
Publishing country | United States |
Document type | Journal Article |
ZDB-ID | 759982-1 |
ISSN | 1538-943X ; 0162-1432 ; 1058-2916 |
ISSN (online) | 1538-943X |
ISSN | 0162-1432 ; 1058-2916 |
DOI | 10.1097/MAT.0000000000002175 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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