Evidence map›Paper›PMID 40526696›Full record

Observational studyPloS one2025

Ultra-massive fluid transfusion in adult liver transplant recipients: A single center observational study.

Hugh Slifirski, Nattaya Raykateeraroj, Angelica Armellini, Riley Hazard, Jordan Zalcman, Junyan Zhao, Zac Tran, Peter Le, Wendell Zhang, Michael Fink and 4 more

Abstract readObservational Study
In one paragraph

Observational study in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Hugh SlifirskiDepartment of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.
Nattaya RaykateerarojDepartment of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.ORCID 0000-0002-1212-2115
Angelica ArmelliniDepartment of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.
Riley HazardDepartment of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.
Jordan ZalcmanDepartment of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.
Junyan ZhaoDepartment of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.
Zac TranDepartment of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.
Peter LeDepartment of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.ORCID 0000-0003-0949-6287
Wendell ZhangDepartment of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.
Michael FinkDepartment of Surgery (Austin Precinct), The University of Melbourne, Melbourne, Victoria, Australia.ORCID 0000-0002-9684-4691
Marcos Vinicius PeriniDepartment of Surgery (Austin Precinct), The University of Melbourne, Melbourne, Victoria, Australia.
Anoop N KoshyDepartment of Cardiology, Austin Health, Heidelberg, Victoria, Australia.
Dong-Kyu LeeDepartment of Anaesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea (the Republic of).ORCID 0000-0002-4068-2363
Laurence WeinbergDepartment of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.ORCID 0000-0001-7403-7680

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPatients undergoing liver transplantation may require large volumes of fluid to maintain hemodynamic stability and treat coagulopathy. This study aimed to determine the prevalence of ultra-massive fluid transfusion and to examine its association with clinical outcomes. We defined an ultra-massive fluid transfusion a priori as a transfusion volume of >20 liters of crystalloids, colloids, blood and blood products administered intraoperatively and within the first 24 hours postoperatively.

methodsThis single-center retrospective observational study included all adult patients who underwent an orthotopic liver transplant and received an ultra-massive fluid transfusion. The primary aim was to determine the prevalence of ultra-massive fluid transfusion in patients undergoing liver transplantation. Secondary objectives included evaluating the effect of the total volume of fluid and packed red blood cell transfusions on postoperative complications, mechanical ventilation hours, intensive care unit and hospital length of stay, and mortality.

resultsOf the 844 liver transplantation procedures, 81 (9.6%) required an ultra-massive fluid transfusion with a median transfusion volume of 36.8 liters (IQR: 31.2-48.7). Each additional liter of fluid administered during surgery was associated with an additional stay of 0.47 days in intensive care (95%CI: 0.18-0.76, p = 0.003). Each additional unit of packed red blood cells administered during surgery was associated with an additional 12.8 hours of mechanical ventilation (95%CI: 3.12-22.43, p = 0.014) and 1.0 additional day in intensive care (95%CI: 0.27-1.79, p = 0.012). Neither ultra-massive fluid transfusion nor packed red blood cell transfusions were associated with increased complications.

conclusionApproximately one in ten liver transplantation patients required an ultra-massive fluid transfusion. While ultra-massive fluid transfusion was associated with prolonged recovery, it was not associated with an increased risk of complications or mortality.

Indexed as

Blood TransfusionFluid TherapyLiver TransplantationAdultAgedErythrocyte TransfusionFemaleHumansLength of StayMaleMiddle AgedPostoperative ComplicationsRetrospective Studies

Identifiers

PMID40526696
PMCPMC12173374

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.