Quality Improvement in Transfusion Practice of Orthotopic Liver Transplantation Reduces Blood Utilization, Length of Hospital Stay, and Cost

ABSTRACT Objectives Orthotopic liver transplantation (OLT) can require substantial usage of blood products. Higher rates of transfusion have been associated with increased length of hospital stay, higher rates of infection, graft failure, and mortality. This study was a retrospective analysis to ass...

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Bibliographic Details
Published in:American journal of clinical pathology 2019-03, Vol.151 (4), p.395-402
Main Authors: Nedelcu, Elena, Wright, Martha Frances, Karp, Seth, Cook, Makenzie, Barbu, Otilia, Eichbaum, Quentin
Format: Article
Language:English
Subjects:
Blood
Blood products
Blood Transfusion - economics
Costs and Cost Analysis
Data collection
Demography
Female
Graft rejection
Grafts
Health risk assessment
Hospitalization
Humans
Length of Stay - economics
Liver transplantation
Liver Transplantation - economics
Liver transplants
Male
Middle Aged
Original
Quality control
Quality Improvement
Retrospective Studies
Statistical analysis
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Summary:ABSTRACT Objectives Orthotopic liver transplantation (OLT) can require substantial usage of blood products. Higher rates of transfusion have been associated with increased length of hospital stay, higher rates of infection, graft failure, and mortality. This study was a retrospective analysis to assess the impact of quality improvement interventions in OLT. Methods Data collection included demographics, preoperative and intraoperative data, blood utilization, and cost data. Statistical analysis was performed using R software. Results Total blood product utilization was reduced by approximately 50%. Statistically significant decreases were noted in blood product usage in the intraoperative and first 48-hour postoperative utilization, the number of OLTs using fewer than five RBC units, length of hospital stay, and cost. Conclusions This study showed successful implementation of quality improvement team interventions to reduce blood utilization during OLT. Reduced transfusion significantly correlated with decreased length of hospital stay and cost.
ISSN:0002-9173
1943-7722
DOI:10.1093/ajcp/aqy154