What are the possible transfusion-related reactions following liver transplantation?

Updated: Apr 19, 2019
  • Author: Vanessa A Olcese, MD, PhD; Chief Editor: Ron Shapiro, MD  more...
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Transfusion reactions are well described in the literature. They include acute intravascular immune hemolytic reactions from ABO incompatibility, delayed immune hemolytic reactions, and febrile reactions. The risk of a fatal hemolytic reaction is less than 1 in 1 million. Febrile reactions, believed to be cytokine-mediated, are also similar to transfusion-related lung injury, which can manifest as adult respiratory distress syndrome.

Platelet transfusions have been identified as an independent risk factor for survival after OLT. A retrospective analysis by Pereboom et al showed that patient survival and graft survival after OLT were significantly reduced in patients who received platelet transfusions, as compared with those who did not (74% vs 92% patient survival, and 69% vs 85% graft survival, at 1 y). [40] Lower survival rates in patients who received platelets were attributed to a significantly higher rate of early mortality because of acute lung injury (4.4% vs 0.4%).

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