| ObjectiveAt present,liver transplantation has become an effective method for the treatment of end-stage liver disease.However,due to the rich blood vessels near the liver,the surgical incision is large,and patients undergoing surgery often have abnormal blood coagulation,resulting in blood loss during and after surgery.Therefore,in order to maintain the stability of the cycle and ensure oxygen supply to vital organs,a large number of allogeneic blood transfusions are required.A large number of allogeneic blood transfusions result in poor prognosis of patients undergoing liver transplantation,and they are prone to induce a variety of adverse reactions to reduce the survival rate.Therefore,a large number of transfusions of allogeneic blood have certain defects and risks.If perioperative hemoglobin(Hb)is less than70g/L in patients with liver transplantation in our hospital,recombinant human erythropoietin(rHuEPO)will be given at the same time as transfusion,however,there is no relevant research on the efficacy and safety of EPO in such patients.Therefore,in this study,the perioperative application of erythropoietin in liver transplantation was studied to evaluate the effect and safety of recombinant human erythropoietin(rHuEPO)in the perioperative period of liver transplantation.MethodsThe data of 89 patients underwent liver transplantation from September 2015 to December 2016 in our hospital were collected.Death case,second liver transplantation and>50 units allogeneic red blood cell suspensiontransfusion were excluded(n=5).The final84 patients were divided into the EPO group and the Control group according to whether rHuEPO was applied.Patients in EPO group received subcutaneous injection of rHuEPO,10000U/ times according to doctor's advice to treat anemia.42 cases in Control group were not treated with rHuEPO.Collecting laboratory examination data of patients,including hemoglobin(Hb),red blood cell count(RBC),reticulocyte count(RET)and so on.The time and dose of rHuEPO administration and the amount of leucocyte suspension suspended in perioperative period were collected.Adverse drug reactions after treatment with rHuEPO were recorded,including fever,headache,dizziness,nausea,rash,and thrombosis.Results1.There was no significant difference in hemoglobin at 3 days after operation(T1),7days after operation(T2),15 days after operation(T3)and 1 months after operation(T4)compared with the preoperative basic values(T0)in EPO group(P >0.05).However,the hemoglobinat T1,T2,T3,T4 of the Control group were significantly lower than that at T0(P<0.01).Hemoglobin at T0 in EPO group was significantly lower than that of in control group(P <0.01).Hemoglobin at T3,T4 in EPO group was significantly higher than that in control group(P <0.05).2.After rHuEPO treatment,there was no significant difference in erythrocyte count(RBC)at T1,T2,T3,T4 compared with that at T0 in EPO group(P >0.05).The RBC in Control group at T1,T2,T3,T4 was significantly lower than that in EPO group(P <0.05).The RBC at T1,T2,T3 and T4 inControl group were significant lower than that in EPO group(P <0.05).3.After rHuEPO treatment,the reticulocyte count at T3 and T4 in EPO group was significantly higher than that in Control group(P <0.01).The reticulocyte count at the T3 and T4 was significantly higher than T0 point in the EPO group(P<0.01).There was no significant difference about the reticulocyte count at T1,T2,T3,T4 compared with that at T0 in Control group(P >0.05).The reticulocyte count in EPO group at T3 and T4 was significantly higher than that in the control group(P <0.01).No complications of thromboembolic complications were observed.There were not fever,headache,dizziness,vomiting,skin rash,thrombosis and other adverse reactions in EPO group.ConclusionSubcutaneous injection of rHuEPO in perioperative patients with anemia of liver transplantation can promote red blood cell mobilization.Compared with the control group,intraoperative blood transfusion does not increase,and the patient's anemia after one month is improved better than the control group,suggesting that rHuEPO is safe and effective for severe patients with liver transplantation anemia. |
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