Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942011000300003
Brazilian Journal of Anesthesiology
Scientific Article

Associação entre uso de hemocomponentes e mortalidade em cinco anos após transplante hepático

Association between the use of blood components and the five-year mortality after liver transplant

Bruno Salome de Morais; Marcelo Dias Sanches; Agnaldo Soares Lima; Daniel Dias Ribeiro; Teresa Cristina de Abreu Ferrari; Malvina Maria de Freitas Duarte; Guilherme Henrique Gomes Moreira Cançado

http://dx.doi.org/10.1590/S0034-70942011000300003 Braz J Anesthesiol, vol.61, n3, p.289-292, 2011
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Resumo

JUSTIFICATIVA E OBJETIVOS: A cirurgia de transplante hepático (TH) continua associada a sangramento importante em 20% dos casos, e diversos autores têm demonstrado os riscos relacionados ao uso de hemocomponentes. O objetivo deste estudo foi avaliar o impacto do uso de hemocomponentes durante toda a hospitalização na sobrevida em cinco anos de pacientes submetidos a TH. MÉTODOS: Um total de 113 pacientes submetidos ao TH foi avaliado retrospectivamente. Diversas variáveis, incluindo uso de hemocomponentes no intraoperatório e durante toda a hospitalização, foram categorizadas e avaliadas por meio de análise univariada, pelo teste de Fisher. O nível de significância adotado foi de 5%. Os resultados com p < 0,2 foram submetidos a uma análise multivariada pelo modelo de regressão logística multinominal. RESULTADOS: Doenças parenquimatosas, disfunção renal pré-operatória e maior tempo de internação no CTI e hospitalar se associaram a maior mortalidade em cinco anos após o TH (p < 0,05). Ao contrário do uso de hemocomponentes no intraoperatório, a transfusão acumulada de concentrado de hemácias, plasma fresco congelado e concentrado de plaquetas durante toda a internação hospitalar foi associada à maior mortalidade em cinco anos após o transplante de fígado (p < 0,01). CONCLUSÕES: O estudo alerta para a relação existente entre o uso de hemocomponentes durante a hospitalização e o aumento da mortalidade em cinco anos após o TH.

Palavras-chave

CIRURGIA, Transplante, COMPLICAÇÕES, SANGUE

Abstract

BACKGROUND AND OBJECTIVES: Liver transplant (LT) surgery is associated with significant bleeding in 20% of cases, and several authors have demonstrated the risks related to blood components. The objective of the present study was to evaluate the impact of using blood components during hospitalization in five-year survival of patients undergoing LT. METHODS: One hundred and thirteen patients were evaluated retrospectively. Several variables, including the use of blood components intraoperatively and throughout hospitalization, were categorized and evaluated by univariate analysis using Fisher's test. A level of significance of 5% was adopted. Results with p < 0.2 underwent multivariate analysis using multinomial logistic regression. RESULTS: Parenchymal diseases, preoperative renal dysfunction, and longer stay in hospital and ICU are associated with greater five-year mortality after LT (p < 0.05). Unlike the intraoperative use of blood components, the accumulated transfusion of packed red blood cell, frozen fresh plasma, and platelets during the entire hospitalization was associated with greater five-year mortality after liver transplantation (p < 0.01). CONCLUSIONS: This study emphasizes the relationship between the use of blood components during hospitalization and increased mortality in five years after LT.

Keywords

Blood Component Transfusion, Liver Transplantation, Fatal Outcome

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