Transfusion practices in cirrhotic patients at a tertiary liver care center from Northern India
Introduction: Transfusion in cirrhotic patients remains a challenge due to the absence of evidence-based guidelines. Our study aimed to determine the indication of transfusion and the associated transfusion thresholds in cirrhotic patients. Methods: This retrospective observational study was conduct...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-07-01
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| Series: | Hematology, Transfusion and Cell Therapy |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2531137920300985 |
| _version_ | 1818573749821112320 |
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| author | Brinda Kakkar Rakhi Maiwall Meenu Bajpai |
| author_facet | Brinda Kakkar Rakhi Maiwall Meenu Bajpai |
| author_sort | Brinda Kakkar |
| collection | DOAJ |
| description | Introduction: Transfusion in cirrhotic patients remains a challenge due to the absence of evidence-based guidelines. Our study aimed to determine the indication of transfusion and the associated transfusion thresholds in cirrhotic patients. Methods: This retrospective observational study was conducted in the Department of Transfusion Medicine at a tertiary care liver center from October 2018 to March 2019. The blood bank and patient records of cirrhotic patients admitted during the study period were retrieved and analyzed to determine the current transfusion practice. Results: A total of 992 cirrhotic patients were included in the study. Blood components were transfused to 402 (40.5%) patients. Sixty-nine (17.2%) patients were transfused to control/treat active bleeding, while 333 (82.8%) were transfused prophylactically. Packed red blood cells (65.4%) was the most commonly transfused blood component, followed by fresh frozen plasma (35.6%), among patients receiving transfusions (therapeutic & prophylactic). The mean pre-transfusion thresholds for: (i) packed red blood cell transfusion: hemoglobin less than 7 g/dL; (ii) fresh frozen plasma transfusion: international normalized ratio over 2.6; (iii) platelet concentrate transfusion: platelet count less than 40,700/μL, and; (iv) cryoprecipitate transfusion: fibrinogen less than 110 mg/dL. The average length of stay of the study population was 5 days (3–9). Conclusion: To conclude, 40.5% of our hospitalized cirrhotic patients were transfused, with the majority of the transfusions being prophylactic (82.8%). Separate guidelines are required for this patient population, as these patients have an altered hemostasis which responds differently to the transfusion of blood components. |
| first_indexed | 2024-12-15T00:17:04Z |
| format | Article |
| id | doaj.art-cefcb1379e5349678813263f87b05230 |
| institution | Directory Open Access Journal |
| issn | 2531-1379 |
| language | English |
| last_indexed | 2024-12-15T00:17:04Z |
| publishDate | 2021-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Hematology, Transfusion and Cell Therapy |
| spelling | doaj.art-cefcb1379e5349678813263f87b052302022-12-21T22:42:26ZengElsevierHematology, Transfusion and Cell Therapy2531-13792021-07-01433280286Transfusion practices in cirrhotic patients at a tertiary liver care center from Northern IndiaBrinda Kakkar0Rakhi Maiwall1Meenu Bajpai2Institute of Liver and Biliary Sciences, New Delhi, IndiaInstitute of Liver and Biliary Sciences, New Delhi, IndiaCorresponding author at: Department of Transfusion Medicine, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi 110070, India.; Institute of Liver and Biliary Sciences, New Delhi, IndiaIntroduction: Transfusion in cirrhotic patients remains a challenge due to the absence of evidence-based guidelines. Our study aimed to determine the indication of transfusion and the associated transfusion thresholds in cirrhotic patients. Methods: This retrospective observational study was conducted in the Department of Transfusion Medicine at a tertiary care liver center from October 2018 to March 2019. The blood bank and patient records of cirrhotic patients admitted during the study period were retrieved and analyzed to determine the current transfusion practice. Results: A total of 992 cirrhotic patients were included in the study. Blood components were transfused to 402 (40.5%) patients. Sixty-nine (17.2%) patients were transfused to control/treat active bleeding, while 333 (82.8%) were transfused prophylactically. Packed red blood cells (65.4%) was the most commonly transfused blood component, followed by fresh frozen plasma (35.6%), among patients receiving transfusions (therapeutic & prophylactic). The mean pre-transfusion thresholds for: (i) packed red blood cell transfusion: hemoglobin less than 7 g/dL; (ii) fresh frozen plasma transfusion: international normalized ratio over 2.6; (iii) platelet concentrate transfusion: platelet count less than 40,700/μL, and; (iv) cryoprecipitate transfusion: fibrinogen less than 110 mg/dL. The average length of stay of the study population was 5 days (3–9). Conclusion: To conclude, 40.5% of our hospitalized cirrhotic patients were transfused, with the majority of the transfusions being prophylactic (82.8%). Separate guidelines are required for this patient population, as these patients have an altered hemostasis which responds differently to the transfusion of blood components.http://www.sciencedirect.com/science/article/pii/S2531137920300985Transfusion practiceCirrhosisThresholdsBlood transfusionCoagulopathy |
| spellingShingle | Brinda Kakkar Rakhi Maiwall Meenu Bajpai Transfusion practices in cirrhotic patients at a tertiary liver care center from Northern India Hematology, Transfusion and Cell Therapy Transfusion practice Cirrhosis Thresholds Blood transfusion Coagulopathy |
| title | Transfusion practices in cirrhotic patients at a tertiary liver care center from Northern India |
| title_full | Transfusion practices in cirrhotic patients at a tertiary liver care center from Northern India |
| title_fullStr | Transfusion practices in cirrhotic patients at a tertiary liver care center from Northern India |
| title_full_unstemmed | Transfusion practices in cirrhotic patients at a tertiary liver care center from Northern India |
| title_short | Transfusion practices in cirrhotic patients at a tertiary liver care center from Northern India |
| title_sort | transfusion practices in cirrhotic patients at a tertiary liver care center from northern india |
| topic | Transfusion practice Cirrhosis Thresholds Blood transfusion Coagulopathy |
| url | http://www.sciencedirect.com/science/article/pii/S2531137920300985 |
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