Massive transfusion in adult patients undergoing liver transplantation

This study will use patient data from a single-centre to investigate the association of ultra-massive transfusion and in-hospital complications in adult patients undergoing liver transplantation from 1 January 2019 to 1 January 2023. Ultra-Massive Transfusion is a relatively new term that has generally been accepted to describe the transfusion of >20 units of packed red blood cells (RBC) in 24 hours. Using routinely collected in-hospital data from the patients electronic medical records, this study will identify the proportion of adult patients who undergo liver transplantation who receive an ultra-massive transfusion. Ultra-massive fluid transfusion will defined a priori as a total transfusion > 20 liters of crystalloids, colloids, blood, and coagulation factors adminsitered intraoperatively and within 24-hours post surgery. Pre-operative risk factors for necessitating ultra-massive transfusion will be investigated. Secondary aims will investigate the relationship between the amount of pack red blood cells transfused and postoperative complications until hospital discharge. Mortality will be collected until 3 years post transplant. Finally, we will evaluate the effects of the co-transfused fresh frozen plasma to packed red blood cells ratio on postoperative complications. and mortality up until 3 years post-transplant.