Plasma Transfusion in Patients With Cirrhosis in China: A Retrospective Multicenter Cohort Study |
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| Affiliation: | 1. Department of Blood Transfusion, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China;2. Department of Blood Transfusion, Third Affiliated Hospital, Sun Yat-sen University, Guangdong, China;3. Department of Blood Transfusion, 302 Hospital of Chinese People''s Liberation Army, Beijing, China;4. Department of Blood Transfusion, Chongqing Three Gorges Central Hospital, Chongqing, China;5. Department of Blood Transfusion, The First Hospital of China Medical University, Liaoning, China;6. Department of Blood Transfusion, General Hospital of Guangzhou Military Command of Chinese People''s Liberation Army, Guangdong, China;7. Department of Blood Transfusion, 307 Hospital of Chinese People''s Liberation Army, Beijing, China;8. Department of Blood Transfusion, General Hospital of Chinese People''s Liberation Army (301 Hospital), Beijing, China;9. Department of Blood Transfusion, Urumqi General Hospital of Chinese People''s Liberation Army, Xinjiang, China;10. Department of Blood Transfusion, Xijing Hospital, The Fourth Military Medical University, Shanxi, China;11. Department of Blood Transfusion, Beijing Hospital, Beijing, China;12. NHS Blood and Transplant/Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, United Kingdom;13. Department of Gastroenterology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China;1. Cellular and Molecular Research Center, Biochemistry Department, Iran University of Medical Sciences, Tehran, Iran;2. Tehran University of Medical Sciences, Tehran, Iran |
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| Abstract: | Patients with cirrhosis used to be associated with frequent use of blood components because of their complex disorder of hemostasis and bleeding complications. Recent findings have indicated that patients with cirrhosis have a state of “rebalanced” or even procoagulant hemostasis and have questioned the prophylactic use of plasma. To evaluate the current status of plasma use in patients with cirrhosis, we conducted a retrospective survey in 11 tertiary-care hospitals in China from September 1 to October 31, 2013. All patients admitted with cirrhosis during the study period were included in the study. The survey collected information including patients' diagnostic and demographic data, clinical course including bleeding complications and invasive procedures, laboratory results, and plasma transfusion data. Among 1595 patients with cirrhosis admitted to the 11 hospitals, 236 (14.8%) patients received 1 or more plasma transfusions during the study period. The number of plasma transfusions is defined as the number of transfusion orders. A total of 1037 plasma transfusions were administered to these patients, with a mean of 4.4 transfusions per transfused patient, ranging from 1 to 22 transfusions per transfused patient. Most plasma transfusions (760/1037; 73.3%) were given to patients without bleeding, for treatment of coagulopathy either without planned invasive procedures (70.4%) or before invasive procedures (2.9%). The median dose of plasma transfusion was 3.8 mL/kg. The rate of plasma transfusion of participating hospitals varied from 5.3% to 31.8%. It is encouraging to see that in one teaching hospital, 85.7% plasma transfusions were given to patients with bleeding indication, showing a promising sign in appropriate transfusion. Prophylaxis or empirical plasma transfusion is still a common problem in managing patients with liver cirrhosis. Wide variations are found in plasma transfusion practice among hospitals. Effective measures to control and reduce empirical correction of abnormal coagulation tests through transfusing plasma should be strengthened urgently. |
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