Abstract: Objective This study was to define independent risk factors of perioperative blood transfusion in patient who need a lung transplant using laboratory findings,operation methods and bleeding complications to provide the basis for clinical prediction of blood use and blood products preparation. Methods The medical records of 260 lung transplant patients in our hospital from July 2017 to July 2020 were retrospectively reviewed. These patients were divided into non-transfusion group（n=46）and blood transfusion group（n=214） according to receipt of perioperative blood transfusion. The clinical data and laboratory examinations were compared between two groups. Clinical and laboratory variables,such as patients' basic information,surgical conditions,preoperative and postoperative laboratory examinations,and extracorporeal membrane oxygenation（ECMO） related information,were compared using univariate analysis,and binary logistic regression were performed. Results In the univariate analysis,the difference between the two groups in disease course more than 7 years（P<0.05）,ASA Ⅳ（P<0.01）,double lung transplantation（P<0.001）,donor cold ischemia time>340 min（P<0.05）,lung transplantation duration>250 min（P<0.001）,blood loss>400 mL（P<0.001）,preoperative Hb reduction（P<0.05）,preoperative Hct reduction（P<0.05）,preoperative PT>15 s（P<0.05）,postoperative PT>15 s（P<0.05）,postoperative PTA<80%（P<0.05）,postoperative APTT>43.5 s（P<0.001）showed statistically significant.The index of P<0.1 in univariate analysis were performed in binary logistic regression analysis. The results showed that the postoperative APTT>43.5 s, double lung transplantation,intraoperative blood loss>400 mL,ECMO use,disease course>7 years were independent risk factors for perioperative blood transfusion in lung transplantation. Conclusion The postoperative APTT>43.5 s, double lung transplantation,intraoperative blood loss>400 mL, perioperative use of ECMO,and disease duration more than 7 years increased risk for blood transfusion. Evaluation of surgical methods and improvement of preoperative coagulation function and hemoglobin level are conducive to prepare blood products.

Key words: Lung transplantation, ECMO, Allogenetic transfusion, Coagulation function