Original Contributions *Head, Section of Anesthesia for General Surgery and Liver Transplantation †Staff Anesthesiologist ‡Clinical Research Nurse, Division of Anes- thesiology & Critical Care Medicine §Medical Director of Liver Transplant Pro- gram, Inova Fairfax Hospital, Fairfax, VA Epidemiologist, Department of Epidemiol- ogy & Biostatistics ¶Surgical Director, Liver Transplantation **Chairman, Department of General Sur- gery Address correspondence to Dr. Parker, Head, Section of Anesthesia for General Sur- gery & Liver Transplantation, Department of General Anesthesiology/E31, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. E-mail: parkerb1@ccf.org Supported in part by a grant from the Re- search Programs Council of the Cleveland Clinic Foundation, Cleveland, OH. Leuko- cyte depletion filters were kindly provided by Pall Biomedical Products Corporation, East Hills, NY. Received for publication June 17, 2002; re- vised manuscript accepted for publication April 10, 2003. Leukocyte Reduction during Orthotopic Liver Transplantation and Postoperative Outcome: A Pilot Study Brian M. Parker, MD,* Samuel A. Irefin, MD,† Vivek Sabharwal, MD,† John E. Tetzlaff, MD,† Carrie Beven, RN,‡ Zobair Younossi, MD,§ Matthew T. Karafa, MS, David P. Vogt, MD,¶ J. Michael Henderson, MD** Department of General Anesthesiology, Cleveland Clinic Foundation, Cleveland, OH; Transplant Center, Cleveland Clinic Foundation; Inova Fairfax Hospital, Fairfax, VA; and the Department of Epidemiology and Biostatistics, Cleveland Clinic Foundation, Cleveland, OH Study Objective: To investigate the effect of intraoperative leukocyte reduction of administered blood products on the incidence of acute cellular rejection and postoperative patient outcome. Design: Prospective, nonrandomized, historical control study. Setting: Academic tertiary medical center. Patients: The study group (Group 1) consisted of 30 consecutive adult patients with end-stage liver disease scheduled to undergo orthotopic liver transplantation (OLT) between 1998 and 2000. The historical control group (Group 2) consisted of 30 adult patients with end-stage liver disease matched to study group patients as closely as possible for age, gender, and etiology of liver disease who underwent OLT between 1995 and 1999. Interventions: Group 1 patients had all intraoperative allogeneic and cell salvaged blood products leukocyte reduced before administration. Group 2 patients underwent OLT without leukocyte filtration of any administered blood products. Measurements: Demographic data were collected for both patient groups and included age, gender, etiology of liver disease, and both intraoperative and postoperative immuno- suppression. Demographic allograft donor data for both patient groups were collected and included age, gender, use of vasopressors during procurement, and cold and warm donor organ ischemic times. Outcome variables measured included incidence of acute cellular rejection, length of intensive care unit (ICU) and length of hospital stay, incidence of both graft loss and retransplantation, and mortality. Main Results: The incidence of acute cellular rejection was 40% in Group 1 and 66.7% in Group 2 (p = 0.037). Length of ICU stay was 3.0 (2.0, 5.0) days in Group 1 and 4.0 (3.0, 6.0) days in Group 2 (p = 0.16). Length of hospital stay was 14.0 (11.0, 18.0) days in Group 1 and 18.0 (14.0, 27.0) days in Group 2 (p = 0.035). One allograft was lost Journal of Clinical Anesthesia 16:18 –24, 2004 © 2004 Elsevier Inc. All rights reserved. 0952-8180/04/$–see front matter 360 Park Avenue, South, New York, NY 10010 doi:10.1016/j.jclinane.2003.04.002