Autologous blood storage before hepatectomy for hepatocellular carcinoma with underlying liver disease

Abstract

Background: Preoperative autologous blood donation has been suggested for patients with liver disease who are to undergo liver resection. The aim of this retrospective study was to clarify the risk factors for increased blood loss and the need for blood transfusion during hepatectomy for hepatocellular carcinoma (HCC).Methods: From January 1996 to December 2000, 206 consecutive patients, 98·5 per cent of whom had underlying liver disease, underwent elective hepatectomy for HCC.Results: Major hepatectomy was performed in 34 patients (16·5 per cent) and minor hepatectomy in 172 patients (83·5 per cent). The mean blood loss was 410 (median 260) ml. Eleven (5·3 per cent) of the 206 patients received blood transfusion during or after the operation. Operation time (P = 0·004) and central venous pressure (CVP) (P = 0·041) were independently correlated with blood loss of more than 1000 ml. Only preoperative haemoglobin level (P = 0·001) was independently correlated with the need for blood transfusion. Conclusion:In patients with underlying liver disease, maintaining CVP at a level below 5 cmH 2 O during parenchymal transection to reduce blood loss is more important than reserving autologous blood before the operation.

Clinicopathologic features of poorly differentiated hepatocellular carcinoma

“…Although advances in surgical techniques and perioperative management have made hepatic resection a safe procedure [19] and have made it possible to improve the prognosis of resectable HCC cases, the incidence of recurrence of HCC has remained high and continues to be the main cause of late death. Cumulative recurrence rates in the liver remnant have been reported to be over 75% [20][21][22][23][24][25][26].…”

Treatment strategy for early hepatocellular carcinomas: Comparison of radiofrequency ablation with or without transcatheter arterial chemoembolization and surgical resection

“…One-third of the liver parenchyma could be resected for patients with ICGR 15 of 10-19%, segmentectomy was possible with ICGR 15 of 20-29%, and limited resection was possible with ICGR 15 of 30% and more [16]. The procedures of hepatectomy were the same as those described previously [17,18].…”

Administration of Antithrombin III Attenuates Posthepatectomy Liver Failure in Hepatocellular Carcinoma

“…One-third of the liver parenchyma could be resected for patients with a retention rate of 10-19%; segmentectomy was possible for patients with a retention rate of 20-29%; and limited resection was possible for patients with a retention rate of ≥30% [12]. Hepatectomy procedures followed those described previously by Itamoto et al [13,14]. …”

“…Among these patients, 164 received postoperative administration of antithrombin III (AT-III-treated group) and 169 did not (non-AT-III-treated group). The type of hepatectomy selected was based on liver function and tumor extent [12,13,14]. Liver function was assessed with Child-Pugh classification [15] and indocyanine green retention rate at 15 min.…”