Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

28 January 2016 : Original article  

Post-Operative Hemorrhage After Liver Transplantation: Risk Factors and Long-Term Outcome

Harald SchremABCDEFG, Annika KlußmannBCDEF, Moritz FockenBE, Nikos EmmanouilidisBDE, Felix OldhaferBDE, Jürgen KlempnauerBDEG, Alexander KaltenbornABCDEFG

DOI: 10.12659/AOT.895605

Ann Transplant 2016; 21:46-55


BACKGROUND: Increasing scarcity of donated liver grafts clearly demonstrates the desperate need for ongoing outcome analysis to improve patient and graft survival after liver transplantation. Coagulation is often severely deteriorated in patients suffering from liver disease, thus leading to bleeding complications after liver transplantation.

MATERIAL AND METHODS: We included 770 liver transplantations in this single-center retrospective analysis to identify independent risk factors for post-operative hemorrhage. The relevance of bleeding complications was assessed with special regards to coagulation-related variables. Multivariate regression analyses allowed weighing of different risk factors.

RESULTS: Post-operative hemorrhage leading to revision surgery was observed in 19.9% (n=153 cases) of cases and was revealed as an independent risk factor for mortality (p=0.014; HR: 1.457; 95%-CI: 1.081–1.964). Risk-adjusted multivariate regression analysis compiling all pre- and intra-operative donor and recipient variables revealed that only the number of transfused packed red blood cells (p<0.001; OR: 1.072; 95%-CI: 1.036–1.110), hepatitis B virus-related liver disease (p=0.019; OR: 0.082; 95%-CI: 0.010–0.666), model of end-stage liver disease-era (p=0.020; OR: 1.016; 95%-CI: 1.002–1.029), partial thromboplastin time at transplantation (p=0.021; OR: 1.016; 95%-CI: 1.002–1.029), and donor intensive care unit stay in days (p=0.009; OR: 1.009; 95%-CI: 1.002–1.016) were significantly associated with the occurrence of post-operative hemorrhage.

CONCLUSIONS: Post-operative hemorrhage relevantly contributed post-transplant mortality. Avoidance of excessive packed red blood cell use during transplantation and short donor-intensive care unit stay lead to a decreased rate of bleeding complications. Coagulations state at transplantation is also relevant for favorable outcome.

Keywords: Blood Platelets, Hemorrhage, Liver Transplantation, Platelet Count, Thrombocytopenia



17 June 2022 : Case report  

Extrapulmonary Manifestations of SARS-CoV-2: A Report of 3 Cases and a Literature Review

Ann Transplant In Press; DOI: 10.12659/AOT.935874  

12 April 2022 : Letter/Correspondence  

Pancreas Allograft Thrombosis as a Post-COVID-19 Complication in a Diabetic Patient After Pancreas Transpla...

Ann Transplant 2022; 27:e935863

12 November 2021 : Original article  

Coronavirus Disease 2019 (COVID-19) in Solid Organ Transplant Recipients: A Case-Control Study

Ann Transplant 2021; 26:e933152

26 October 2021 : Original article  

Safety of Antithymocyte Globulin Use in Kidney Graft Recipients During the COVID-19 Pandemic

Ann Transplant 2021; 26:e933001

In Press

23 Jun 2022 : Original article  

Evaluation of Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program in Comparison to S...

Ann Transplant In Press; DOI: 10.12659/AOT.936514  

21 Jun 2022 : Case report  

Extrapulmonary Manifestations of SARS-CoV-2: A Report of 3 Cases and a Literature Review

Ann Transplant In Press; DOI: 10.12659/AOT.935874  

20 Jun 2022 : Original article  

The Association Between Tacrolimus Levels and Hyperkalemia in Allograft Recipients Who Underwent Heart or L...

Ann Transplant In Press; DOI: 10.12659/AOT.935607  

15 Jun 2022 : Original article  

Donor CYP3A5 Expression Decreases Renal Transplantation Outcomes in White Renal Transplant Recipients

Ann Transplant In Press; DOI: 10.12659/AOT.936276  

Most Viewed Current Articles

26 Jan 2022 : Review article  

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

DOI :10.12659/AOT.934924

Ann Transplant 2022; 27:e934924

29 Dec 2021 : Original article  

Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...

DOI :10.12659/AOT.933588

Ann Transplant 2021; 26:e933588

24 Jul 2020 : Review article  

Kidney Transplantation in the Times of COVID-19 – A Literature Review

DOI :10.12659/AOT.925755

Ann Transplant 2020; 25:e925755

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358