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Transfusion Requirements in Liver Transplantation

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Safety and Efficacy of Tranexamic Acid to Minimise Perioperative Bleeding in Hepatic Surgery: A Systematic Review and Meta-Analysis.

Amanda Koh, Alfred Adiamah, Dhanwant Gomez, Sudip Sanyal,

<h4>Introduction</h4>Perioperative bleeding poses a major risk during liver surgery, which can result in increased transfusion requirements, morbidity, and mortality. Tranexamic acid (TXA) effectively reduces perioperative bleeding and transfusion requirements in trauma patients. However, there remains a lack of evidence of its use in liver surgery. This meta-analysis of randomised controlled ... Read more >>

World J Surg (World journal of surgery)
[2021, :]

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Disseminated intravascular coagulation following air embolism during orthotropic liver transplantation: is this just a coincidence?

Karolina Arstikyte, Gintare Vitkute, Vilma Traskaite-Juskeviciene, Andrius Macas,

<h4>Background</h4>During orthotopic liver transplantation, venous air embolism may occur due to iatrogenic injury of the inferior vena cava. However, venous air embolism followed by coagulopathy is a rare event. In this case report, we discuss a possible connection between venous air embolism and disseminated intravascular coagulation.<h4>Case presentation</h4>A 37-year-old male patient ... Read more >>

BMC Anesthesiol (BMC anesthesiology)
[2021, 21(1):264]

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Improving Ineffective Erythropoiesis in Thalassemia: A Hope on the Horizon

Ujjwal Madan, Himani Bhasin, Pooja Dewan, Jyotsna Madan,

Beta-thalassemia is an inherited hemoglobinopathy characterized by the impaired synthesis of beta-globin chains of hemoglobin leading to chronic hemolytic anemia. The mainstay of treatment for most patients remains regular blood transfusions and iron chelation. This conventional therapy has many limitations and challenges. Allogeneic hematopoietic stem cell transplant (HSCT) is the ... Read more >>

Cureus (Cureus)
[0, 13(10):]

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Effect of Preoperative Continuation of Aspirin on Postoperative Bleeding After Off-Pump Coronary Artery Bypass Graft: A Prospective Cohort Study

Muhammad Ishtiaque Al-Manzo, Saikat DasGupta, Sonjoy Biswas, Bappy Basak, Md. Ziaur Rahman, Samir Kumar Biswas, Quamrul Islam Talukder, Prasanta K Chanda, Farooque Ahmed,

Background Despite ample evidence of continuing preoperative aspirin to improve coronary artery bypass surgery outcomes, practice for the routine continuation of preoperative aspirin is inconsistent due to concern for increased postoperative bleeding. The purpose of this study was to investigate preoperative aspirin use and its effect on postoperative bleeding after ... Read more >>

Cureus (Cureus)
[0, 13(10):]

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Impact of the Share 35 Policy on Perioperative Management and Mortality in Liver Transplantation Recipients.

Warangkana Lapisatepun, Vatche G Agopian, Victor W Xia, Worakitti Lapisatepun,

BACKGROUND The Share 35 policy was introduced in 2013 by the Organ Procurement and Transplantation Network (OPTN) to increase opportunities of sicker patients to access liver transplantation. However, it has the disadvantage of higher MELD score associated with adverse postoperative transplant outcomes. Early data after implementation of the Share 35 ... Read more >>

Ann Transplant (Annals of transplantation)
[2021, 26:e932895]

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Baseline haemoglobin and thromboelastometry are predictive of red blood cell requirements and one-year mortality in liver transplantation.

Laura Viguera, Annabel Blasi, Enric Reverter, Begoña Arjona, Marta Caballero, Ivette Chocron, José Antonio García-López, Rosa Gutierrez, Maria Jesús Martin, Jose Pérez-Peña, Javier Pitera, Iratxe Zarragoikoetxea, Antoni Sabaté,

<h4>Background</h4>To determine the predictive capacity of baseline haemoglobin and maxim clot firmness (MCF) EXTEM thromboelastometry for intraoperative red blood cell (RBC) requirements and its influence on mortality.<h4>Methods</h4>591 adult liver transplant (LT) recipients from ten Spanish centres were reviewed. The main outcomes were the percentage of patients who received RBC and ... Read more >>

Transfus Apher Sci (Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis)
[2021, :103259]

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Viscoelastic monitoring in liver transplantation.

Selvakumar Malleeswaran, Sivanesan Sivajothi, Mettu Srinivas Reddy,

Cirrhosis and liver transplantation surgery are associated with substantial alterations to the patient's coagulation status. Accurate monitoring of these changes during liver transplantation can help manage bleeding proactively and potentially reduce transfusion requirements. Unlike conventional coagulation tests, visco-elastic monitoring can provide an accurate, real-time, point-of-care assessment of coagulation status during ... Read more >>

Liver Transpl (Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society)
[2021, :]

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Transfusion requirements and alloimmunization to red blood cell antigens in orthotopic liver transplantation.

Ajna Uzuni, Jaber El-Bashir, Dragos Galusca, Sirisha Yeddula, Shunji Nagai, Atsushi Yoshida, Marwan S Abouljoud, Zaher K Otrock,

<h4>Background and objectives</h4>Orthotopic liver transplantation (OLT) has been associated with high blood transfusion requirements. We evaluated the transfusion needs and frequency of alloimmunization to RBC antigens among OLT recipients pre- and post-transplantation.<h4>Materials and methods</h4>We reviewed the medical records of patients who underwent a first OLT between January 2007 and June ... Read more >>

Vox Sang (Vox sanguinis)
[2021, :]

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An Update on the Management of Esophageal Variceal Hemorrhage

Hassaan A. Zia, Elizabeth S. Aby, Atoosa Rabiee,

Content available: Author Audio Recording ... Read more >>

Clin Liver Dis (Hoboken) (Clinical liver disease)
[2021, 18(4):179-183]

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Hepatic Steatosis is Associated with an Increased Risk of Postoperative Infections and Perioperative Transfusion Requirements in Patients Undergoing Hepatectomy.

Diego Villagomez, Malay Shah, Francesc Marti, Gabriel Orozco, Daniel Davenport, Meera Gupta, Alexandre Ancheta, Siddharth Desai, Gabriel Vilchez, Joseph Zwischenberger, Roberto Gedaly,

<h4>Background</h4>To determine the impact of hepatic steatosis on perioperative outcomes of patients undergoing hepatectomy.<h4>Methods</h4>We analyzed all hepatectomy patients with normal and fatty liver texture, between 2014 and 2018 using NSQIP. Main endpoints included perioperative transfusions (within 72 h) and infectious complications.<h4>Results</h4>A total of 8,237 patients underwent hepatectomy during the study period. ... Read more >>

World J Surg (World journal of surgery)
[2021, 45(12):3654-3659]

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Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine.

Alexander P J Vlaar, Joanna C Dionne, Sanne de Bruin, Marije Wijnberge, S Jorinde Raasveld, Frank E H P van Baarle, Massimo Antonelli, Cecile Aubron, Jacques Duranteau, Nicole P Juffermans, Jens Meier, Gavin J Murphy, Riccardo Abbasciano, Marcella C A Müller, Marcus Lance, Nathan D Nielsen, Herbert Schöchl, Beverley J Hunt, Maurizio Cecconi, Simon Oczkowski,

<h4>Purpose</h4>To develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults.<h4>Methods</h4>A taskforce involving 15 international experts and 2 methodologists used the GRADE approach to guideline development. The taskforce addressed three main topics: transfusion support in massively and non-massively bleeding critically ill patients (transfusion ratios, blood ... Read more >>

Intensive Care Med (Intensive care medicine)
[2021, :]

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Iron overload during the treatment of acute leukemia: pretransplant transfusion experience

Osman Yokus, Celalettin Herek, Tahir Alper Cinli, Hasan Goze, Istemi Serin,

<h4>Background:</h4> Recent studies have shown the increased risk of mortality in cases with acute leukemia and iron overload. We aimed to determine the status of iron overload in patients with acute leukemia. <h4>Materials & Methods:</h4> Patients diagnosed with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) between January 2015 ... Read more >>

Int J Hematol Oncol (International journal of hematologic oncology)
[2021, 10(3):]

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Minimally invasive liver resection for huge (≥10 cm) tumors: an international multicenter matched cohort study with regression discontinuity analyses

Tan-To Cheung, Xiaoying Wang, Mikhail Efanov, Rong Liu, David Fuks, Gi-Hong Choi, Nicholas L. Syn, Charing C. Chong, Iswanto Sucandy, Adrian K. H. Chiow, Marco V. Marino, Mikel Gastaca, Jae Hoon Lee, T. Peter Kingham, Mathieu D’Hondt, Sung Hoon Choi, Robert P. Sutcliffe, Ho-Seong Han, Chung Ngai Tang, Johann Pratschke, Roberto I. Troisi, Brian K. P. Goh, International Robotic and Laparoscopic Liver Resection Study Group Collaborators,

<h4>Background</h4> The application and feasibility of minimally invasive liver resection (MILR) for huge liver tumours (≥10 cm) has not been well documented. <h4>Methods</h4> Retrospective analysis of data on 6,617 patients who had MILR for liver tumours were gathered from 21 international centers between 2009–2019. Huge tumors and large tumors were ... Read more >>

(Hepatobiliary Surgery and Nutrition)
[2021, 10(5):587-597]

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Transfusion-free Retransplantation for Post-liver Transplantation Hepatic Artery Thrombosis: How Much Augmentation Is Too Much?

Ashwini Mulgaonkar, Brian Horwich, Brian Kim, Jeffrey A Kahn, Navpreet Kaur, Yuri Genyk, Hyosun Han, Aaron Ahearn,

Liver transplantation presents unique challenges in patients who do not accept blood transfusions. The difficulty of balancing chemical augmentation and handling the technical difficulty of the surgery make transfusion-free liver transplantation an exception rather than the norm. However, at our center, we have performed 27 successful living donor liver transplants ... Read more >>

Transplant Direct (Transplantation direct)
[2021, 7(11):e776]

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Post COVID-19 multisystem inflammatory syndrome in children undergoing hematopoietic stem cell transplant

Anjali Yadav, Dhwanee Thakkar, K. Upasana, Sunisha Arora, Neha Rastogi, Satya Prakash Yadav,

(Pediatric Hematology Oncology Journal)
[2021, :]

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Avatrombopag: A Review in Thrombocytopenia.

Anthony Markham,

Avatrombopag (Doptelet<sup>®</sup>) is an orally administered second generation thrombopoietin receptor agonist (TPO-RA) approved for the treatment of primary chronic immune thrombocytopenia (ITP) in adult patients who are refractory or have an unsatisfactory response to other treatments, as well as for the treatment of thrombocytopenia in adult patients with chronic liver ... Read more >>

Drugs (Drugs)
[2021, 81(16):1905-1913]

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Predictors of mortality and outcomes of liver transplant in spur cell hemolytic anemia.

Zain M Virk, Arpan A Patel, Rebecca K Leaf, Hanny Al-Samkari,

Spur cell hemolytic anemia (SCHA) is a rare, acquired, nonimmune hemolytic anemia of decompensated cirrhosis. Data describing prognostic impact, outcomes of liver transplant, and clinical hematologic characteristics of SCHA are absent or limited. We performed a multicenter, 24-year observational cohort study of patients with SCHA, retrospectively analyzing hepatic and hematologic ... Read more >>

Am J Hematol (American journal of hematology)
[2021, :]

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The prognostic role of in-hospital transfusion of fresh frozen plasma in patients with cholangiocarcinoma undergoing curative-intent liver surgery.

Jan Bednarsch, Zoltan Czigany, Lara R Heij, Tom Luedde, Sven H Loosen, Marcel den Dulk, Philipp Bruners, Sven A Lang, Tom F Ulmer, Ulf P Neumann,

<h4>Introduction</h4>Major hepatectomy for perihilar and intrahepatic cholangiocarcinoma (CCA) is often associated with a significant intraoperative blood loss and the requirement for perioperative transfusion of blood products. The aim of this study was to investigate the oncological impact of fresh frozen plasma (FFP) transfusion during hospitalization in patients undergoing hepatectomy for ... Read more >>

Eur J Surg Oncol (European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology)
[2021, :]

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Comparative Propensity Matched Outcomes in Severe COVID-19 Respiratory Failure-Extracorporeal Membrane Oxygenation or Maximum Ventilation Alone.

Asif K Mustafa, Devang J Joshi, Philip J Alexander, Deborah R Tabachnick, Chadrick A Cross, Eias E Jweied, Nitesh S Mody, Marc H Huh, Subia Fasih, Pat S Pappas, Antone J Tatooles,

<h4>Objective</h4>Does extracorporeal membrane oxygenation (ECMO) improve outcomes in ECMO-eligible patients with COVID-19 respiratory failure compared to maximum ventilation alone (MVA)?<h4>Summary background data</h4>ECMO is beneficial in severe cases of respiratory failure when mechanical ventilation is inadequate. Outcomes for ECMO-eligible COVID-19 patients on MVA have not been reported. Consequently, a direct comparison ... Read more >>

Ann Surg (Annals of surgery)
[2021, 274(5):e388-e394]

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Quantitation of residual D positive red cells in D negative recipients of D positive solid organ transplants.

Vera Rosa, Matthew Hazell,

<h4>Background</h4>Solid organ transplants (SOT) from D positive donors are potentially sensitising events for D negative recipients. For this reason, it is important to quantify the presence of residual D positive red blood cells (RBCs) in the recipient's circulation and calculate the correct dose of prophylactic anti-D (PAD) required to prevent ... Read more >>

Transfus Med (Transfusion medicine (Oxford, England))
[2021, :]

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Prevalence, Risk Factors, and Outcomes of Platelet Transfusion Refractoriness in Critically Ill Patients: A Retrospective Cohort Study.

Saeed Arabi, Abdullah O Almahayni, Abdulrahman A Alomair, Emad M Masuadi, Moussab Damlaj, Hasan M Al-Dorzi,

<h4>Background</h4>Refractoriness to platelet transfusion is an understudied phenomenon in critically ill patients. Our objective was to evaluate the prevalence, risk factors, and clinical outcomes of platelet refractoriness among patients in a tertiary-care intensive care unit (ICU).<h4>Methods</h4>A retrospective cohort study included all patients (age >14 years) who were admitted to a ... Read more >>

Crit Care Res Pract (Critical care research and practice)
[2021, 2021:5589768]

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Prognostic Association Between Perioperative Red Blood Cell Transfusion and Postoperative Cardiac Surgery Outcomes.

Yanxiu Li, Iokfai Cheang, Zhongwen Zhang, Xiangrong Zuo, Quan Cao, Jinghang Li,

<b>Objective:</b> To investigate the correlation between red blood cell transfusion and clinical outcome in patients after cardiac surgery. <b>Methods:</b> Demographic, clinical characteristics, treatment with/without transfusion, and outcomes of patients after cardiac surgery from the Medical Information Mart for Intensive Care-III database were collected. Patients were divided into two groups according ... Read more >>

Front Cardiovasc Med (Frontiers in cardiovascular medicine)
[2021, 8:730492]

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MRD negative CR after azacitidine and venetoclax in a young patient with AML, unfit for intensive induction followed by ASCT.

Deepak Kumar Shukla, Satyendra Katewa, Ravikant Porwal, Ravi Dara, Lalit Sharma, Rahul Sharma, Aadesh Arora,

A subset of AML patients are unfit for 7+3 induction at the time of diagnosis. Present case highlights the use of azacitidine and venetoclax in a patient with intermediate risk AML with WT-1 mutation,deemed unfit for intensive induction in view of poor general condition and comorbid illness. After venetoclax and ... Read more >>

Leuk Res Rep (Leukemia research reports)
[2021, 16:100267]

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Minimally invasive liver resection for huge (≥10 cm) tumors: an international multicenter matched cohort study with regression discontinuity analyses.

Tan-To Cheung, Xiaoying Wang, Mikhail Efanov, Rong Liu, David Fuks, Gi-Hong Choi, Nicholas L Syn, Charing C Chong, Iswanto Sucandy, Adrian K H Chiow, Marco V Marino, Mikel Gastaca, Jae Hoon Lee, T Peter Kingham, Mathieu D'Hondt, Sung Hoon Choi, Robert P Sutcliffe, Ho-Seong Han, Chung Ngai Tang, Johann Pratschke, Roberto I Troisi, Brian K P Goh, ,

<h4>Background</h4>The application and feasibility of minimally invasive liver resection (MILR) for huge liver tumours (≥10 cm) has not been well documented.<h4>Methods</h4>Retrospective analysis of data on 6,617 patients who had MILR for liver tumours were gathered from 21 international centers between 2009-2019. Huge tumors and large tumors were defined as tumors ... Read more >>

Hepatobiliary Surg Nutr (Hepatobiliary surgery and nutrition)
[2021, 10(5):587-597]

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Epidemiology of Bleeding in Critically Ill Children With an Underlying Oncologic Diagnosis

Juliana Romano, Mario Martinez, Julie Levasseur, James S. Killinger, Oliver Karam, Marianne E. Nellis,

Supplemental Digital Content is available in the text. <h4>OBJECTIVES:</h4> Critically ill children with malignancy have significant risk of bleeding but the exact epidemiology is unknown. We sought to describe severe bleeding events and associated risk factors in critically ill pediatric patients with an underlying oncologic diagnosis using the newly developed ... Read more >>

Crit Care Explor (Critical care explorations)
[2021, 3(11):]

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