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Int J Surg. 2018 May;53:48-52. doi: 10.1016/j.ijsu.2018.02.053. Epub 2018 Feb 28.

Anaemia in patients with chronic liver disease and its association with morbidity and mortality following liver transplantation.

Author information

1
Division of Surgery and Interventional Science, Royal Free Campus, University College London (UCL), Pond Street, London NW3 2QG, United Kingdom.
2
Division of Surgery and Interventional Science, Royal Free Campus, University College London (UCL), Pond Street, London NW3 2QG, United Kingdom. Electronic address: francis.robertson.13@ucl.ac.uk.
3
Division of Surgery and Interventional Science, Royal Free Campus, University College London (UCL), Pond Street, London NW3 2QG, United Kingdom; HPB and Liver Transplant Unit, Royal Free London NHS Foundations Trust, Pond St, London, NW3 2QG, United Kingdom.

Abstract

Pre-operative anaemia and the need for intra-operative transfusion have been associated with increased morbidity and mortality following cardiac and major non-cardiac surgery. Anaemia is highly prevalent in patients with severe chronic liver disease. Whether this correlates with an altered morbidity and mortality following liver transplant has not been established.

METHODS:

Prospectively collected data was analysed for the period 1998-2012. Donor and recipient characteristics, blood profiles and complications were recorded. Graft and patient survival was calculated. All patients were followed up for 1 year or until death. Pre-operative haemoglobin levels were correlated with patient demographics and outcome using a binary logistic regression analysis.

RESULTS:

Pre-operative anaemia, according to WHO criteria, occurred in 73% of patients. Anaemia was more common with advanced liver disease (higher MELD score). As MELD score increased, Haemoglobin levels dropped. Anaemic patients were more commonly transfused (p < 0.001), spent longer ventilated (7 day vs 5 days, p = 0.005) and required longer ITU stays (8 days vs 6 days, p = 0.015). Pre-operative anaemia did not correlate with patient morbidity or mortality.

CONCLUSIONS:

Reduced haemoglobin levels reflect the severity of chronic liver disease but are not an independent risk factor for a poor outcome following liver transplantation.

KEYWORDS:

Anaemia; Liver transplantation; Morbidity; Mortality

PMID:
29499362
DOI:
10.1016/j.ijsu.2018.02.053
[Indexed for MEDLINE]

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