Pustavoitau et al reported a modified risk index (ModRI) for massive transfusion in a patient undergoing liver transplant. This can help to identify a patient who is more or less likely to require a large number of blood products. The authors are from the Johns Hopkins University, University of Maryland and Aga Khan University in Karachi.
Patient selection: liver transplant recipient
Parameters:
(1) hemoglobin in g/dL
(2) platelet count in 10^9/L
(3) thromboelastography (TE) R interval in minutes
(4) simultaneous liver and kidney transplant
(5) liver retransplantation
Parameter
Finding
Points
hemoglobin
>= 10 g/dL
0
< 10 g/dL
1
platelet count
>= 100 * 10^9/L
0
< 100 * 10^9/L
1
TE R interval
<= 6 minutes
0
> 6 minutes
1
liver and kidney transplant
no
0
yes
1
liver retransplant
no
0
yes
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• A score > 2 is associated with risk of massive transfusion.
Performance:
• The area under the ROC curve is 0.72.
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