{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:22:14Z","timestamp":1787016134613,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K08\u2010AI155816"],"award-info":[{"award-number":["K08\u2010AI155816"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unanticipated transfusion requirements during liver transplantation can delay lifesaving intraoperative resuscitation and strain blood bank resources. Risk\u2010stratified preoperative blood preparation can mitigate these deleterious outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>A two\u2010tiered blood preparation protocol for liver transplantation was retrospectively evaluated. Eleven binary variables served as criteria for high\u2010risk (HR) allocation. Primary outcomes included red blood cell (RBC), plasma (FFP), and platelet (Plt) utilization. Secondary outcomes included product under\u2010 and overpreparation. Contingency tables for transfusion requirements above the population means were generated using 15 clinical variables. Modified protocols were developed and retrospectively optimized using the study population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 225 recipients, 102 received HR preoperative orders, which correlated to higher intraoperative transfusion requirements. However, univariate analysis identified only two statistical risk factors per product: Hgb \u22647.8\u2009g\/dl (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) and MELD \u226538 (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.035) for RBCs, Hgb \u22647.8\u2009g\/dl (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.002) and acute alcoholic hepatitis (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.015) for FFP, and Hgb \u22647.8\u2009g\/dl (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.001) and normothermic liver preservation (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.037) for Plts. Based on these findings, we developed modified protocols for individual products, which were evaluated retrospectively for their effectiveness at reducing under\u2010preparatory events while limiting product overpreparation. Cohort statistics were used to define the preparation strategy for each protocol. Retrospective comparative analysis demonstrated the superiority of the modified protocols by improving the under\u2010preparation rate from 24% to &lt;10% for each product, which required a 1.56\u2010fold and 1.44\u2010fold increase in RBC and FFP overpreparation, respectively. Importantly, there was no difference in Plt overpreparation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>We report translatable data\u2010driven blood bank preparation protocols for liver transplantation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.17074","type":"journal-article","created":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T06:39:54Z","timestamp":1660977594000},"page":"2057-2067","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Blood products and liver transplantation: A strategy to balance optimal preparation with effective blood stewardship"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9723-2366","authenticated-orcid":false,"given":"Christopher J.","family":"Little","sequence":"first","affiliation":[{"name":"Division of Transplantation, Department of Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen E.","family":"Leverson","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura L.","family":"Hammel","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1799-8335","authenticated-orcid":false,"given":"Joseph P.","family":"Connor","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4469-6375","authenticated-orcid":false,"given":"David P.","family":"Al\u2010Adra","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,20]]},"reference":[{"issue":"1","key":"e_1_2_7_2_1","first-page":"1","article-title":"Consensus Conference on Indications of Liver Transplantation. 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