Abstract
Background: This study analyzed the status and trends of transfusion and its associated factors among liver and kidney transplantation recipients. Methods: A total of 10,858 and 16,191 naïve liver or kidney transplantation recipients from 2008 to 2017 were identified through the National Health Insurance Service database. The prescription code for transfusion and the presence, number, and amount of each type of transfusion were noted. The odds ratios and 95% confidence intervals were determined to identify significant differences in transfusion and blood components by liver and kidney transplantation recipient characteristics. Results: In this study, 96.4% of liver recipients and 59.7% of kidney recipients received transfusions related to the transplantation operation, mostly platelet and fresh frozen plasma. Higher perioperative transfusion in women and declining transfusion rates from 2008 to 2017 were observed in both liver and kidney recipients. In liver recipients, the transfusion rate in those who received organs from deceased donors was much higher than that in those who received organs from living donors; however, the mortality rate according to transfusion was higher only in recipients of deceased donor organs. In kidney recipients, a higher mortality rate was observed in those receiving transfusion than that in patients without transfusion. Conclusions: In Korea, the transfusion rates in liver and kidney recipients were relatively higher than those in other countries. Sociodemographic factors, especially sex and year of transplantation, were associated with transfusion in solid organ recipients, possibly as surrogates for other causal clinical factors.
Highlights
Solid organ transplantation is a lifesaving procedure for patients with end-stage organ dysfunction [1]
The results of this study showed the transfusion rates and transfusion amounts related to transplantation surgery among liver and kidney transplantation recipients in Korea from 2008 to 2017
Studies with relatively lower transfusion rates have shown that approximately 75–80% of liver recipients did not receive any blood products and only 0.5 or fewer mean red blood cells (RBCs) units were required in 500 liver transplantations [10,11,12]
Summary
Solid organ transplantation is a lifesaving procedure for patients with end-stage organ dysfunction [1]. Over 140,000 solid organ transplantations were performed worldwide in 2018, a number that has continuously increased from 41,259 in 2000. Sensitization could be caused by factors including previous transplant, pregnancy, or blood transfusion. A recent study suggested that RBC transfusion negatively affected liver transplantation recipient survival [7]. Based on these results, it has been suggested that an active effort to minimize blood transfusion is required to prevent sensitization, despite the relatively low risk in naïve recipients [6]. This study analyzed the status and trends of transfusion and its associated factors among liver and kidney transplantation—the two main types of organ transplantation in Korea using a population-based nationwide database
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