The Impact of Intraoperative Donor Blood on Packed Red Blood Cell Transfusion During Deceased Donor Liver Transplantation: A Retrospective Cohort Study

BACKGROUND Blood from deceased organ donors, also known as donor blood, has the potential to reduce the need for packed red blood cells (PRBCs) during liver transplantation (LT). We hypothesized that donor blood removed during organ procurement is a viable resource that could reduce the need for PRBCs during LT. METHODS We retrospectively examined data on LT recipients over the age of 18 years who underwent a deceased donor LT. The primary aim was to compare the incidence of PRBC transfusion in LT patients who received intraoperative donor blood (the DB group) to those who did not (the non-donor blood [NDB] group). RESULTS After a propensity score matching process, 175 patients received donor blood and 175 did not. The median (1st-3rd quartile) volume of donor blood transfused was 690.0 mL (500.0-900.0), equivalent to a median of 3.1 units (2.3-4.1). More patients in the NDB group received an intraoperative PRBC transfusion than in the DB group: 74.3% [95% CI: 80.8-67.8] compared to 60% [95% CI: 67.3-52.7]; P = 0.004. The median number of PRBCs transfused intraoperatively was higher in the NDB group compared to the DB group: 3 units (0-6) compared to 2 units (0-4); P = 0.004. There were no significant differences observed in the secondary outcomes. CONCLUSIONS Use of donor blood removed during organ procurement and reinfused to the recipient is a viable resource for reducing the requirements for PRBCs during LT. Use of donor blood minimizes the exposure of the recipient to multiple donor sources.