Relative decrease in hemoglobin and outcomes in patients und
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Recent surgical literature suggests that a relative decrease in hemoglobin (ΔHb) is predictive of adverse outcomes regardless of the absolute level. Relative change in recipient hemoglobin is associated with inferior transplant outcomes. Hemoglobin decline of ≥30% is identified as the threshold for this.

Researchers aimed to examine the association between perioperative ΔHb and kidney transplantation (KT) outcomes. This study was published by the American Journal of Surgery.

This was a retrospective cohort study of transplant recipients, where ΔHb= [Hb0– Hb1/Hb0]x 100 (Hb 0=hemoglobin pre-KT and Hb 1=lowest hemoglobin 24-h post-KT). The main outcome of interest was immediate graft function (IGF).

Of the 899 eligible patients, 38% experienced IGF, and ΔHb was associated with 36% lower odds of IGF. Also, ΔHb was associated with higher all-cause graft failure and longer length of stay but not death-censored graft failure or mortality. ΔHb ≥30% was the threshold beyond which the odds of IGF were significantly lower even if Hb 1 was ≥7 g/dL.

Conclusively, ΔHb is associated with inferior outcomes independent of Hb 1; whether it can be used to guide transfusion practices should be explored.

Source: https://doi.org/10.1016/j.amjsurg.2021.03.002
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