{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:05:56Z","timestamp":1747188356061,"version":"3.40.5"},"reference-count":12,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T00:00:00Z","timestamp":1609200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A patient\u02bcs hemoglobin is typically expected to rise by 1 g\/dL\/unit transfused PRBCs. However, it has been theorized that mechanisms such as hyperbilirubinemia and splenomegaly might lead to either a direct lysis or sequestration of red blood cells that could decrease this proportionate response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>Patients with resolved GI bleeding but still requiring transfusion to correct anemia were compared in cirrhosis and control groups. A retrospective chart review between 2015 and 2020 was conducted at a single institution. Data collected included age, sex, BMI, GI bleed diagnosis, number of PRBCs transfused, presence of splenomegaly and spleen size, alcohol use history, type of cirrhosis, MELD\u2010Na at admission, GFR, and pre\u2010and post\u2010transfusion labs: total bilirubin, ALT, hemoglobin, hematocrit. A logic regression was performed for each group looking at which factors were associated with a successful response (defined as &gt;0.9 g\/dL hemoglobin per unit transfused).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean change in hemoglobin was 0.77\u2009g\/dL in patients with cirrhosis compared to 1.46\u2009g\/dL in patients without (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001, N = 103). Odds ratios for presence of splenomegaly (0.22, N = 78) and female sex (4.39, N = 102) in predicting adequate response (&gt;0.9 g\/dL\/unit) were both significant (<jats:italic>P<\/jats:italic> = .002) as well as portal hypertensive bleed diagnosis (0.28, N = 85, <jats:italic>P<\/jats:italic> = .0015). Factors that did not contribute included: age, race, BMI, alcohol use, GFR, change in ALT, and change in total bilirubin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with cirrhosis have an approximately 50% decreased response to transfusion with PRBCs after resolution of a gastrointestinal bleed in comparison to patients without cirrhosis. Risk factors included splenomegaly, portal hypertension, and male sex.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.16238","type":"journal-article","created":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T13:19:14Z","timestamp":1609247954000},"page":"708-712","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Post\u2010transfusion hemoglobin response in patients with cirrhosis: Can we expect a 1 g\/dL rise per unit transfused?"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8833-2362","authenticated-orcid":false,"given":"Nicholas","family":"Noverati","sequence":"first","affiliation":[{"name":"Pennsylvania State University College of Medicine  Hershey Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Federici","sequence":"additional","affiliation":[{"name":"Division of Hematology\u2010Oncology, Department of Medicine Penn State Milton S Hershey Medical Center  Hershey Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"Thomas R.","family":"Riley","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine Penn State Milton S Hershey Medical Center  Hershey Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,29]]},"reference":[{"volume-title":"Hematology: clinical and laboratory practice","year":"1993","author":"Bick RL","key":"e_1_2_7_2_1"},{"key":"e_1_2_7_3_1","first-page":"35","volume-title":"Transfusion therapy, principles and procedures","author":"Johnston M","year":"1985"},{"key":"e_1_2_7_4_1","first-page":"423","volume-title":"Blood transfusion in clinical medicine","author":"Jones J","year":"1993"},{"volume-title":"Laboratory hematology","year":"1984","author":"Koepke JA","key":"e_1_2_7_5_1"},{"volume-title":"Leavell and Thorup's fundamentals of clinical hematology","year":"1987","author":"Leavell BS","key":"e_1_2_7_6_1"},{"volume-title":"Principles of transfusion medicine","year":"1991","author":"Rossi EC","key":"e_1_2_7_7_1"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1967.tb08844.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI104997"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14876"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27338"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI105622"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.5402\/2012\/298345"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.16238","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.16238","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.16238","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T18:39:46Z","timestamp":1693334386000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.16238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,29]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1111\/trf.16238"],"URL":"https:\/\/doi.org\/10.1111\/trf.16238","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"type":"print","value":"0041-1132"},{"type":"electronic","value":"1537-2995"}],"subject":[],"published":{"date-parts":[[2020,12,29]]},"assertion":[{"value":"2020-08-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}