Background: Although many previous studies have confirmed that perioperative blood transfusion is associated with poor outcomes after liver transplantation (LT), few studies described the influence of single-donor ...Background: Although many previous studies have confirmed that perioperative blood transfusion is associated with poor outcomes after liver transplantation (LT), few studies described the influence of single-donor platelet apheresis transfusion in living donor LT (LDLT). This study aimed to assess the effect of blood products on outcomes for LDLT recipients, focusing on apheresis platelets. Methods: This retrospective study included 126 recipients who underwent their first adult-to-adult LDLT. Twenty-four variables including consumption of blood products of 126 LDLT recipients were assessed for their link to short-term outcomes and overall survival. Kaplan-Meier survival curve and the log-rank test were used for recipient survival analysis. A multivariate Cox proportional-hazard model and a propensity score analysis were applied to adjust confounders after potential risk factors were identified by a univariate Cox analysis. Results: Patients who received apheresis platelet transfusion had a lower 90-day cumulative survival (78.9% vs. 94.2%, P = 0.009), but had no significant difference in overall survival in the Cox model, compared with those without apheresis platelet transfusion. Units of apheresis platelet transfusion(hazard ratio[HR]=3.103,95% confidence interval[CI]:1.720–5.600,P〈0.001)and preoperative platelet count(HR=0.170,95% CI:0.040–0.730,P=0.017)impacted 90-day survival independently.Multivariate Cox regression analysis also found that units of red blood cell(RBC)transfusion(HR=1.036,95% CI:1.006–1.067,P=0.018),recipient's age(HR=1.045,95% CI:1.005–1.086,P=0.025),and ABO blood group comparison(HR=2.990,95% CI:1.341–6.669,P=0.007)were independent risk factors for overall survival after LDLT. Conclusions: This study suggested that apheresis platelets were only associated with early mortality but had no impact on overall survival in LDLT. Units of RBC, recipient's age, and ABO group comparison were independent predictors of long-term outcomes.展开更多
目的探索利用实时能量代谢检测技术检测单采血小板(AP)中线粒体呼吸功能(MRF)的最佳条件参数,并研究AP在贮存过程中MRF的变化。方法收集AP标本,利用Seahorse XF检测其中MRF,通过调整AP的上样浓度、洗涤条件、线粒体呼吸调节药物浓度等...目的探索利用实时能量代谢检测技术检测单采血小板(AP)中线粒体呼吸功能(MRF)的最佳条件参数,并研究AP在贮存过程中MRF的变化。方法收集AP标本,利用Seahorse XF检测其中MRF,通过调整AP的上样浓度、洗涤条件、线粒体呼吸调节药物浓度等多项参数,最后分别研究贮存1 d和5 d的AP中MRF。结果AP上样浓度为5×10^(7)/100μL时,基础呼吸值316±65为最优;洗涤组的基础呼吸值329±120比未洗涤组的57±7更优(P<0.05);FCCP浓度以2μmol/L为最优。贮存1 d AP的基础呼吸值为683±161,而贮存5 d AP的基础呼吸值为140±23(P<0.05);贮存1 d AP的最大呼吸值为1044±82,而贮存5 d AP最大呼吸值<200(P<0.05)。2组的MRF动力曲线有明显差异。结论实时能量代谢检测技术可以实现对AP中MRF的检测。AP在贮存过程中MRF明显受损,提示这可能是血小板贮存损伤的重要新机制。展开更多
文摘Background: Although many previous studies have confirmed that perioperative blood transfusion is associated with poor outcomes after liver transplantation (LT), few studies described the influence of single-donor platelet apheresis transfusion in living donor LT (LDLT). This study aimed to assess the effect of blood products on outcomes for LDLT recipients, focusing on apheresis platelets. Methods: This retrospective study included 126 recipients who underwent their first adult-to-adult LDLT. Twenty-four variables including consumption of blood products of 126 LDLT recipients were assessed for their link to short-term outcomes and overall survival. Kaplan-Meier survival curve and the log-rank test were used for recipient survival analysis. A multivariate Cox proportional-hazard model and a propensity score analysis were applied to adjust confounders after potential risk factors were identified by a univariate Cox analysis. Results: Patients who received apheresis platelet transfusion had a lower 90-day cumulative survival (78.9% vs. 94.2%, P = 0.009), but had no significant difference in overall survival in the Cox model, compared with those without apheresis platelet transfusion. Units of apheresis platelet transfusion(hazard ratio[HR]=3.103,95% confidence interval[CI]:1.720–5.600,P〈0.001)and preoperative platelet count(HR=0.170,95% CI:0.040–0.730,P=0.017)impacted 90-day survival independently.Multivariate Cox regression analysis also found that units of red blood cell(RBC)transfusion(HR=1.036,95% CI:1.006–1.067,P=0.018),recipient's age(HR=1.045,95% CI:1.005–1.086,P=0.025),and ABO blood group comparison(HR=2.990,95% CI:1.341–6.669,P=0.007)were independent risk factors for overall survival after LDLT. Conclusions: This study suggested that apheresis platelets were only associated with early mortality but had no impact on overall survival in LDLT. Units of RBC, recipient's age, and ABO group comparison were independent predictors of long-term outcomes.
文摘目的探索利用实时能量代谢检测技术检测单采血小板(AP)中线粒体呼吸功能(MRF)的最佳条件参数,并研究AP在贮存过程中MRF的变化。方法收集AP标本,利用Seahorse XF检测其中MRF,通过调整AP的上样浓度、洗涤条件、线粒体呼吸调节药物浓度等多项参数,最后分别研究贮存1 d和5 d的AP中MRF。结果AP上样浓度为5×10^(7)/100μL时,基础呼吸值316±65为最优;洗涤组的基础呼吸值329±120比未洗涤组的57±7更优(P<0.05);FCCP浓度以2μmol/L为最优。贮存1 d AP的基础呼吸值为683±161,而贮存5 d AP的基础呼吸值为140±23(P<0.05);贮存1 d AP的最大呼吸值为1044±82,而贮存5 d AP最大呼吸值<200(P<0.05)。2组的MRF动力曲线有明显差异。结论实时能量代谢检测技术可以实现对AP中MRF的检测。AP在贮存过程中MRF明显受损,提示这可能是血小板贮存损伤的重要新机制。