(P-PB-7) Blood Product Utilization in Heart, Lung and Combined Heart-Lung Transplants: An Institutional Experience

Background/Case Studies: Blood loss is common during organ transplantation due to the complexity of the surgical procedures required. The need for blood components is often determined by the organ transplanted, surgical techniques utilized, and patient dependent factors. Our institution performs multiple types of organ transplant procedures including heart transplants, lung transplants, and we recently started performing combined heart-lung transplants (HLT). Our blood bank records the blood components used for all transplant surgeries as part of our QA program. We were interested in reviewing blood component utilization for individual transplants and how it compared to the utilization in combined transplants.

Study

Design/Methods: Over the course of a year, we performed 22 heart transplants, 6 lung transplants and 4 combined HLTs. The mean utilization was calculated for the four blood components (red blood cells (RBC), plasma, platelets and cryoprecipitate) for each type of transplant surgery.

Results/Findings: Our review revealed that small quantities of blood components were utilized for the individual heart and lung transplants. As expected, a larger quantity of blood components were transfused for combined HLT (Table 1). However, it was of interest that the mean blood component utilization for these combined surgeries exceeded the sum of the mean of the individual heart transplant and lung transplant surgeries (Table 1)

Conclusions: Blood utilization for heart and lung transplants at our institution was surprisingly low and some of the individual organs were transplanted with no blood component transfusions. It was noteworthy that the mean utilization of the combined HLTs exceeded the sum of the mean of the heart and lung transplants. This was likely due to the high complexity of the surgery required for the combined transplants and the longer duration of the surgical procedures. However, the benefits of a single donor of the organs and a single surgical procedure likely offset any disadvantages related to the increased blood component transfusions during combined HLTs.