Register Login

PLASTIC RECONSTRUCTIVE AND REGENERATIVE SURGERY

Abstract

Background - Transfusion-associated circulatory overload (TACO) is a rare life-threatening event associated with transfusion. This study aimed to identify any case of TACO in a large cohort of highly transfused patients with gastrointestinal tract (GI) bleeding.
Materials and methods - Data from patients who underwent an oesophago-gastro-duodenoscopy (OGD) were collected over one year from the gastroenterology service of a regional hospital.
Results - A total of 278 patients were identified, of which 81 required transfusion. In total, 811 blood components were transfused (red cell concentrate, platelets, plasma), leading to a cumulative TACO incidence of 12.3%. The probability of developing TACO was greater for patients aged≥80 years (OR=3.9%; p=0.0058), with renal disease (OR=1.9%, p=not significant) and with cardiac disease (OR 11.1%; p=0.003). Patients with TACO had a lower overall survival (52 vs 20% at 3 years, p=0.034, HR=2.19, 95% CI: 1.04-4.63) compared to patients with cirrhosis without TACO (57 vs 28% at 3 years, p=0.003, HR=2.20, 95% CI: 1.30-3.72). Patients with an advanced stage of liver cirrhosis (Child Pugh c10 or more) were most likely to develop TACO.
Discussion - This study shows that within the GI setting TACO may be markedly under-reported. Clinical awareness for potential TACO development in GI patients with cardiac or renal disease or age >80 years is now required.

References

Downloads

PDF
Authors

Andrea Piccin Department of Haematology and Oncology, Innsbruck Medical University, Innsbruck, Austria; Department of Haematology Oncology, Children’s Health Ireland at Crumlin, Dublin, Ireland; Faculty of Medicine, University of Trento, Trento, Italy

Gilbert Spizzo Department of Haematology and Oncology, Innsbruck Medical University, Innsbruck, Austria; Department of Gastroenterology, “San Maurizio” Regional Hospital, Bolzano, South Tyrol, Italy

Mark A. Popovski Transfusion Department, Harvard University of Medicine, Boston, United States of America

Francesco P. Russo Department of Oncology Surgery, Section Gastroenterology, University of Padova, Padua, Italy

Luca Armanaschi Administrative Department, “San Maurizio” Regional Hospital, Bolzano, South Tyrol, Italy

Cinzia Vecchiato Transfusion Service, “San Maurizio” Regional Hospital, Bolzano, South Tyrol, Italy

Antonio Frena Department of Surgery, “San Maurizio” Regional Hospital, Bolzano, South Tyrol, Italy

Andrea Mega Department of Gastroenterology, “San Maurizio” Regional Hospital, Bolzano, South Tyrol, Italy

  • Abstract viewed - 730 times
  • PDF downloaded - 210 times