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Predictors of Huang et al for Massive Blood Transfusion in a Pediatric Patient Having a Living Donor Liver Transplant

Description

Huang et al identified factors associated with massive blood transfusion for a pediatric patient undergoing a living donor liver transplant. These can help to identify a patient who may benefit from closer monitoring during and after surgery. The authors are from Kaohsiung Chang Gung Memorial Hospital in Taiwan.


Patient selection: pediatric patient undergoing living donor liver transplant

 

Outcome: massive blood transfusion (volume of blood products transfused during surgery greater than the estimated blood volume)

 

The main predictor for massive transfusion was a prolonged INR. For each 0.1 unit increase in the INR there was a 1.083 fold risk of massive blood transfusion.

 

Using 1.1 as the upper limit of the normal reference range (0.9 to 1.1 at the Mayo Clinic Laboratories) this becomes the following equation if the INR is > 1.1.

 

risk of massive transfuion =

= 1.083 ^ ((INR - 1.1) * 10)

 

Increasing the ratio of FFP to RBC units or other steps to reduce the INR reduces the risk of massive blood transfusion


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