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The effect of transfusion of blood products on ventricular assist device support outcomes
- Source :
- ESC Heart Failure, Vol 7, Iss 6, Pp 3573-3581 (2020), ESC Heart Failure
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Aims Perioperative blood transfusions are common among patients undergoing left ventricular assist device (LVAD) implantation. The association between blood product transfusion at the time of LVAD implantation and mortality has not been described. Methods and results This was a retrospective cohort study of all patients who underwent continuous flow LVAD implantation at a single, large, tertiary care, academic centre, from 2008 to 2014. We assessed used of packed red blood cells (pRBCs), platelets, and fresh frozen plasma (FFP). Outcomes of interest included all‐cause mortality and acute right ventricular (RV) failure. Standard regression techniques were used to examine the association between blood product exposure and outcomes of interest. A total of 170 patients were included in this study (mean age: 56.5 ± 15.5 years, 79.4% men). Over a median follow‐up period of 11.2 months, for every unit of pRBC transfused, the hazard for mortality increased by 4% [hazard ratio (HR) 1.04; 95% CI 1.02–1.07] and odds for acute RV failure increased by 10% (odds ratio 1.10; 95% CI 1.05–1.16). This association persisted for other blood products including platelets (HR for mortality per unit 1.20; 95% CI 1.08–1.32) and FFP (HR for mortality per unit 1.08; 95% CI 1.04–1.12). The most significant predictor of perioperative blood product exposure was a lower pre‐implant haemoglobin. Conclusions Perioperative blood transfusions among patients undergoing LVAD implantation were associated with a higher risk for all‐cause mortality and acute RV failure. Of all blood products, FFP use was associated with worst outcomes. Future studies are needed to evaluate whether pre‐implant interventions, such as intravenous iron supplementation, will improve the outcomes of LVAD candidates by decreasing need for transfusions.
- Subjects :
- Adult
Male
medicine.medical_specialty
Ventricular Dysfunction, Right
medicine.medical_treatment
Left ventricular assist device
030204 cardiovascular system & hematology
Right ventricular failure
Transfusions
03 medical and health sciences
0302 clinical medicine
Blood product
Original Research Articles
Internal medicine
medicine
Humans
Diseases of the circulatory (Cardiovascular) system
Blood Transfusion
Original Research Article
030212 general & internal medicine
Aged
Retrospective Studies
business.industry
Hazard ratio
Retrospective cohort study
Perioperative
Odds ratio
Middle Aged
Treatment Outcome
RC666-701
Ventricular assist device
Cardiology
Female
Heart-Assist Devices
Fresh frozen plasma
Cardiology and Cardiovascular Medicine
business
Packed red blood cells
Subjects
Details
- ISSN :
- 20555822
- Volume :
- 7
- Database :
- OpenAIRE
- Journal :
- ESC Heart Failure
- Accession number :
- edsair.doi.dedup.....00db31ece3e02e4e2e1ee6423518c3a2