{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:15:35Z","timestamp":1789143335767,"version":"build-2803163510"},"reference-count":39,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jprasurg.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Plastic, Reconstructive & Aesthetic Surgery"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.bjps.2026.07.045","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T16:34:32Z","timestamp":1786034072000},"page":"143-151","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Predictors and consequences of perioperative blood transfusions in deep inferior epigastric perforator flap breast reconstruction"],"prefix":"10.1016","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7953-7983","authenticated-orcid":false,"given":"Evan J.","family":"Haas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6027-7295","authenticated-orcid":false,"given":"Giovanni","family":"Tin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ansley","family":"Wallace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zain","family":"Aryanpour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason W.","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Winocour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8336-2127","authenticated-orcid":false,"given":"Katie G.","family":"Egan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Mathes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5631-8355","authenticated-orcid":false,"given":"Christodoulos","family":"Kaoutzanis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"1","key":"10.1016\/j.bjps.2026.07.045_bib1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/PRS.0000000000001747","article-title":"Comparison of outcomes following autologous breast reconstruction using the DIEP and pedicled TRAM flaps: a 12-year clinical retrospective study and literature review","volume":"138","author":"Knox","year":"2016","journal-title":"Plast Reconstr Surg"},{"issue":"5","key":"10.1016\/j.bjps.2026.07.045_bib2","doi-asserted-by":"crossref","first-page":"791E","DOI":"10.1097\/PRS.0000000000010379","article-title":"Deliberate practice in DIEP flap breast reconstruction: an immediate and sustained decrease in morbidity and operative time","volume":"152","author":"Haddock","year":"2023","journal-title":"Plast Reconstr Surg"},{"issue":"2","key":"10.1016\/j.bjps.2026.07.045_bib3","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1055\/s-2006-941716","article-title":"The Deep Inferior Epigastric Artery Perforator Flap (DIEAP) in breast reconstruction","volume":"20","author":"Hamdi","year":"2006","journal-title":"Semin Plast Surg"},{"issue":"6","key":"10.1016\/j.bjps.2026.07.045_bib4","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1245\/s10434-017-5807-5","article-title":"Complications in DIEP flap breast reconstruction after mastectomy for breast cancer: a prospective cohort study comparing unilateral versus bilateral reconstructions","volume":"24","author":"Wade","year":"2017","journal-title":"Ann Surg Oncol"},{"key":"10.1016\/j.bjps.2026.07.045_bib5","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.bjps.2023.07.048","article-title":"Prolonged operative time is a risk factor for adverse postoperative outcomes in the unilateral deep inferior epigastric perforator (DIEP) flap surgery: a retrospective cohort study","volume":"87","author":"Shtarbanov","year":"2023","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"7","key":"10.1016\/j.bjps.2026.07.045_bib6","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1002\/micr.30203","article-title":"Time-dependent factors in DIEP flap breast reconstruction","volume":"37","author":"Laporta","year":"2017","journal-title":"Microsurgery"},{"issue":"6S_6","key":"10.1016\/j.bjps.2026.07.045_bib7","doi-asserted-by":"crossref","first-page":"S388","DOI":"10.1097\/SAP.0000000000001341","article-title":"Outcomes of 270 consecutive deep inferior epigastric perforator flaps for breast reconstruction","volume":"80","author":"Zhang","year":"2018","journal-title":"Ann Plast Surg"},{"issue":"8","key":"10.1016\/j.bjps.2026.07.045_bib8","doi-asserted-by":"crossref","first-page":"5409","DOI":"10.1245\/s10434-024-15266-0","article-title":"Simultaneous Co-surgeon Deep Inferior Epigastric Perforator (DIEP) flap breast reconstructions: feasibility and clinical outcomes","volume":"31","author":"Wang","year":"2024","journal-title":"Ann Surg Oncol"},{"issue":"11","key":"10.1016\/j.bjps.2026.07.045_bib9","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1046\/j.1365-2168.2000.01570.x","article-title":"Effects of the combination of blood transfusion and postoperative infectious complications on prognosis after surgery for colorectal cancer. Danish RANX05 Colorectal Cancer Study Group","volume":"87","author":"Mynster","year":"2000","journal-title":"Br J Surg"},{"issue":"3","key":"10.1016\/j.bjps.2026.07.045_bib10","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/j.surg.2015.02.027","article-title":"Blood transfusion and adverse surgical outcomes: the good and the bad","volume":"158","author":"Ferraris","year":"2015","journal-title":"Surgery"},{"issue":"8","key":"10.1016\/j.bjps.2026.07.045_bib11","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1097\/BRS.0000000000001803","article-title":"Association of intraoperative blood transfusions on postoperative complications, 30-day readmission rates, and 1-year patient-reported outcomes","volume":"42","author":"Elsamadicy","year":"2017","journal-title":"Spine"},{"issue":"6","key":"10.1016\/j.bjps.2026.07.045_bib12","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/0007-1226(89)90075-1","article-title":"Inferior epigastric artery skin flaps without rectus abdominis muscle","volume":"42","author":"Koshima","year":"1989","journal-title":"Br J Plast Surg"},{"issue":"4","key":"10.1016\/j.bjps.2026.07.045_bib13","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.bjps.2025.11.049","article-title":"Identifying transfusion criteria and risk factors after deep inferior epigastric artery perforator flap breast reconstruction","volume":"113","author":"Chen","year":"2026","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"4","key":"10.1016\/j.bjps.2026.07.045_bib14","doi-asserted-by":"crossref","first-page":"566E","DOI":"10.1097\/PRS.0000000000010343","article-title":"Predictors of complications in autologous breast reconstruction using DIEP flaps: implications for management","volume":"152","author":"Wu","year":"2023","journal-title":"Plast Reconstr Surg"},{"issue":"10","key":"10.1016\/j.bjps.2026.07.045_bib15","article-title":"Complications and patient-reported outcomes after TRAM and DIEP flaps: a systematic review and meta-analysis","volume":"8","author":"He","year":"2020","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"4","key":"10.1016\/j.bjps.2026.07.045_bib16","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1055\/s-0031-1275486","article-title":"Predictors of blood transfusion in deep inferior epigastric artery perforator flap breast reconstruction","volume":"27","author":"Ting","year":"2011","journal-title":"J Reconstr Microsurg"},{"issue":"5","key":"10.1016\/j.bjps.2026.07.045_bib17","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1097\/SAP.0b013e318268a803","article-title":"Transfusions in autologous breast reconstructions: an analysis of risk factors, complications, and cost","volume":"72","author":"Fischer","year":"2014","journal-title":"Ann Plast Surg"},{"issue":"5","key":"10.1016\/j.bjps.2026.07.045_bib18","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1097\/PRS.0b013e31820cf1dd","article-title":"Risk factors influencing transfusion rates in DIEP flap breast reconstruction","volume":"127","author":"Appleton","year":"2011","journal-title":"Plast Reconstr Surg"},{"issue":"4","key":"10.1016\/j.bjps.2026.07.045_bib19","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1177\/22925503241255118","article-title":"Donor site outcomes following autologous breast reconstruction with DIEP flap: a retrospective and prospective study in a single institution","volume":"33","author":"Fan","year":"2024","journal-title":"Plast Surg"},{"issue":"12","key":"10.1016\/j.bjps.2026.07.045_bib20","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1016\/j.bjps.2013.07.013","article-title":"Blood loss and transfusion rates in DIEP flap breast reconstruction. Introducing a new predictor","volume":"66","author":"Lymperopoulos","year":"2013","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"4","key":"10.1016\/j.bjps.2026.07.045_bib21","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1097\/SAP.0b013e31823ed606","article-title":"Preoperative anemia predicts thrombosis and free flap failure in microvascular reconstruction","volume":"69","author":"Hill","year":"2012","journal-title":"Ann Plast Surg"},{"issue":"10","key":"10.1016\/j.bjps.2026.07.045_bib22","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1016\/j.bjps.2019.06.012","article-title":"Predictors of blood transfusion in autologous breast reconstruction surgery: A retrospective study using the nationwide inpatient sample database","volume":"72","author":"Masoomi","year":"2019","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"6","key":"10.1016\/j.bjps.2026.07.045_bib23","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1097\/01.SAP.0000054181.58934.1E","article-title":"Transfusion requirements for TRAM flap postmastectomy breast reconstruction","volume":"50","author":"Tzilinis","year":"2003","journal-title":"Ann Plast Surg"},{"key":"10.1016\/j.bjps.2026.07.045_bib24","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.bjps.2026.02.038","article-title":"Effect of body mass index in perioperative outcomes in free-flap breast reconstruction surgery","volume":"115","author":"Liang","year":"2026","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"2","key":"10.1016\/j.bjps.2026.07.045_bib25","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s10549-014-3024-5","article-title":"Differential impact of non-insulin-dependent diabetes mellitus and insulin-dependent diabetes mellitus on breast reconstruction outcomes","volume":"146","author":"Qin","year":"2014","journal-title":"Breast Cancer Res Treat"},{"issue":"5","key":"10.1016\/j.bjps.2026.07.045_bib26","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1093\/asj\/sjv241","article-title":"Evaluation of Diabetes Mellitus as a Risk Factor for Major Complications in Patients Undergoing Aesthetic Surgery","volume":"36","author":"Bamba","year":"2016","journal-title":"Aesthetic Surg J"},{"issue":"5","key":"10.1016\/j.bjps.2026.07.045_bib27","doi-asserted-by":"crossref","first-page":"1109e","DOI":"10.1097\/PRS.0000000000005537","article-title":"An assessment of bleeding complications necessitating blood transfusion across inpatient plastic surgery procedures: a nationwide analysis using the national surgical quality improvement program database","volume":"143","author":"Thomas","year":"2019","journal-title":"Plast Reconstr Surg"},{"issue":"4","key":"10.1016\/j.bjps.2026.07.045_bib28","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1002\/micr.22202","article-title":"The impact of anemia on microsurgical breast reconstruction complications and outcomes","volume":"34","author":"Nelson","year":"2014","journal-title":"Microsurgery"},{"issue":"1-2","key":"10.1016\/j.bjps.2026.07.045_bib29","doi-asserted-by":"crossref","DOI":"10.1093\/milmed\/usae325","article-title":"How Much Does Intravenous Fluid Cause Hematocrit to Drop? Improving interpretation of hematocrit toward better post-hemorrhage care","volume":"190","author":"Qureshi","year":"2025","journal-title":"Mil Med"},{"issue":"5","key":"10.1016\/j.bjps.2026.07.045_bib30","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1111\/j.1365-3148.2005.00607.x","article-title":"Recovery from post-operative anaemia","volume":"15","author":"Wallis","year":"2005","journal-title":"Transfus Med"},{"issue":"6","key":"10.1016\/j.bjps.2026.07.045_bib31","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1046\/j.1537-2995.1997.37697335150.x","article-title":"Early changes in hemoglobin and hematocrit levels after packed red cell transfusion in patients with acute anemia","volume":"37","author":"Elizalde","year":"1997","journal-title":"Transfusion"},{"issue":"4","key":"10.1016\/j.bjps.2026.07.045_bib32","doi-asserted-by":"crossref","first-page":"389","DOI":"10.21037\/gs.2019.06.05","article-title":"A systematic review of donor site aesthetic and complications after deep inferior epigastric perforator flap breast reconstruction","volume":"8","author":"Lindenblatt","year":"2019","journal-title":"Gland Surg"},{"issue":"10","key":"10.1016\/j.bjps.2026.07.045_bib33","doi-asserted-by":"crossref","first-page":"2044","DOI":"10.1007\/s00268-007-9159-3","article-title":"Effect of perioperative allogeneic red blood cell transfusion on the immune-inflammatory response after colorectal cancer resection","volume":"31","author":"Ydy","year":"2007","journal-title":"World J Surg"},{"issue":"2","key":"10.1016\/j.bjps.2026.07.045_bib34","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1097\/PRS.0b013e3181aee9a3","article-title":"Salvage of tissue expander in the setting of mastectomy flap necrosis: a 13-year experience using timed excision with continued expansion","volume":"124","author":"Antony","year":"2009","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.bjps.2026.07.045_bib35","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.jss.2025.12.012","article-title":"The association of blood transfusion with free flap survival and thrombosis: a review and meta-analysis","volume":"318","author":"Anuszkiewicz","year":"2026","journal-title":"J Surg Res"},{"issue":"1","key":"10.1016\/j.bjps.2026.07.045_bib36","doi-asserted-by":"crossref","first-page":"E123","DOI":"10.1097\/SLA.0000000000005386","article-title":"Development and assessment of machine learning models for individualized risk assessment of mastectomy skin flap necrosis","volume":"278","author":"Hassan","year":"2023","journal-title":"Ann Surg"},{"issue":"6","key":"10.1016\/j.bjps.2026.07.045_bib37","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1097\/MOH.0000000000000376","article-title":"Transfusion-related immunomodulation: a reappraisal","volume":"24","author":"Youssef","year":"2017","journal-title":"Curr Opin Hematol"},{"issue":"3","key":"10.1016\/j.bjps.2026.07.045_bib38","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.jamcollsurg.2008.04.021","article-title":"Risk factors for surgical site infection after major breast operation","volume":"207","author":"Olsen","year":"2008","journal-title":"J Am Coll Surg"},{"issue":"3","key":"10.1016\/j.bjps.2026.07.045_bib39","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1111\/jth.15195","article-title":"Managing the coagulopathy associated with cardiopulmonary bypass","volume":"19","author":"Bartoszko","year":"2021","journal-title":"J Thromb Haemost"}],"container-title":["Journal of Plastic, Reconstructive & Aesthetic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1748681526004444?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1748681526004444?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:02:28Z","timestamp":1789142548000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1748681526004444"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":39,"alternative-id":["S1748681526004444"],"URL":"https:\/\/doi.org\/10.1016\/j.bjps.2026.07.045","relation":{},"ISSN":["1748-6815"],"issn-type":[{"value":"1748-6815","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Predictors and consequences of perioperative blood transfusions in deep inferior epigastric perforator flap breast reconstruction","name":"articletitle","label":"Article Title"},{"value":"Journal of Plastic, Reconstructive & Aesthetic Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.bjps.2026.07.045","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}