Autologous blood transfusion in patients with hepatocellular carcinoma undergoing hepatectomy

Shinozuka, Nozomi; Koyama, Isamu; Arai, Tsunenori; Numajiri, Yoshikatsu; Watanabe, Takuji; Nagashima, N; Matsumoto, Takashi; Ohata, Masahiko; Anzai, Haruyuki; Omoto, Ryozo

doi:10.1016/s0002-9610(99)00256-1

Cited by 41 publications

(13 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, most of these studies included patients with metastatic liver cancer or benign liver tumours who had normal parenchyma in the non-cancerous region of the liver. Transfusion rates and mean blood loss during hepatectomy for patients suffering from HCC, most of whom in East Asian countries have underlying liver disease, are still over 30 per cent and over 1000 ml respectively 2,15,25 .…”

Section: Discussionmentioning

confidence: 99%

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

Itamoto

Katayama

Nakahara

et al. 2003

British Journal of Surgery

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

Itamoto

Katayama

Nakahara

et al. 2003

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Strategies to minimize the risks of allogeneic blood transfusion are leukocyte-depleted transfusions, short storage time and the use of autologous blood transfusion. Methods for autologous transfusion used in liver surgery include preoperative blood donation [19,45,46,47], intraoperative acute normovolemic hemodilution [48], and intraoperative blood salvage [49, 50]. However, these methods are not common clinical practice yet because of logistical reasons in preoperative blood donation or the required training of the operating team in intraoperative hemodilution.…”

Section: Conclusion and Perspectives For The Futurementioning

confidence: 99%

“…Despite these improvements, blood loss remains one of the main predictors of both perioperative morbidity and mortality after liver resection [7, 10]. The possible negative sequelae of blood transfusions are well known and include alloimmunization [11,12,13,14,15,16], transmission of viral diseases [17], graft-versus-host disease [18], increased postoperative infection rate [16,19,20,21], and increased incidence of tumor recurrence in certain cancers [16,22,23,24,25,26,27]. …”

Section: Introductionmentioning

confidence: 99%

Impact of Blood Loss on Outcome after Liver Resection

Boer¹,

Molenaar²,

Porte³

2007

Dig Surg

139

View full text Add to dashboard Cite

Partial liver resections are the treatment of choice for patients with a malignant liver or bile duct tumor. The most frequent indications for partial liver resections are colorectal metastasis, hepatocellular carcinoma (HCC) and cholangiocarcinoma. Liver resection is the only therapy with a chance for cure in these patients. Refinements in surgical technique and increasing experience have contributed to a reduction in perioperative morbidity and mortality in recent years. Despite these improvements, partial liver resections remain a major surgical procedure and carry the risk for excessive blood loss and a subsequent need for blood transfusion. Blood transfusions have been associated with systemic side effects, such as depression of the immune system. Several studies have suggested that perioperative blood loss or transfusions have a negative impact on postoperative outcome. However, it has been debated whether this is due to a real cause-effect relationship or merely the result of more complicated surgery. We have reviewed the literature concerning studies focusing on the relationship between blood loss and blood transfusion during liver surgery for malignant tumors and postoperative outcome. Most studies were based on a retrospective analysis of single center experiences, using uni- and multivariate statistical methods. Most studies have demonstrated a significant and clinically relevant association between blood transfusion and postoperative mortality and morbidity, especially postoperative infectious complications. The effect of blood transfusions on tumor recurrence and more long-term mortality is much less clear and evidence varies depending on the type of malignancy. The strongest indication that blood transfusion may have an impact on tumor recurrence has been found for patients with early stages of HCC. However, overall, no such effect could be demonstrated for patients undergoing partial liver resection for late stages of HCC, colorectal liver metastasis or cholangiocarcinoma.

show abstract

“…Transfusion rates and mean blood loss during hepatectomy for patients suffering from HCC, most of whom were in the Far East, where patients had underlying liver disease, were still > 30% and >1000 mL, respectively. 3,28,29 The mean intraoperative blood loss was 1700 mL (median 1200 mL) in the present series. A subgroup analysis in the present study showed that 21/103 patients with tumour > 10 cm were significantly associated with more operative blood loss (3344.3 mL vs 1273.5 mL, P = 0.000).…”

Section: Discussionmentioning

confidence: 55%

Recurrence and survival for hepatocellular carcinoma after curative resection: Tertiary centre experience

Li¹,

Cheung²

2008

Surgical Practice

View full text Add to dashboard Cite

Aim:The aim of the present paper was to determine the pattern of recurrence and prediction for survival after primary curative surgical resection of hepatocellular carcinoma (HCC). Methods: This was a retrospective single institutional review. During 2002During -2005 patients had hepatectomies at Queen Elizabeth Hospital The total number of patients with primary curative liver resection was 113, and 103 patients were included in this survival analysis. Results: The recurrence rate was 49/103 (47.6%). The operative mortality rate was 4/113 (3.5%). The median time for recurrence was 13.5 months (range, 1-60 months). The mean follow-up period was 26.03 months (range, 1-60 months).Overall survival was 90%, 72% and 50%, at 1, 3 and 5 years, respectively, and diseasefree survival was 55%, 48% and 42%, at 1, 3 and 5 years, respectively. On univariate analysis, tumour > 10 cm, close (Յ 1 mm)/focally involved/involved resection margin, operative blood loss > 2500 mL, presence of satellite tumour nodules, vascular invasion and poor tumour differentiation were found to be associated with recurrence. On multivariate analysis presence of multiple satellite tumour nodules and presence of vascular invasion predicted poor disease-free survival whereas vascular invasion was the only predictor for overall survival. Conclusion: Patients who had curative surgical resection for HCC should be considered for adjuvant therapy when these high-risk factors are present.

show abstract

Autologous blood transfusion in patients with hepatocellular carcinoma undergoing hepatectomy

Cited by 41 publications

References 9 publications

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

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

Impact of Blood Loss on Outcome after Liver Resection

Recurrence and survival for hepatocellular carcinoma after curative resection: Tertiary centre experience

Contact Info

Product

Resources

About