Impact of Perioperative Blood Transfusions on the Outcomes of Patients Undergoing Kidney Cancer Surgery: A Systematic Review and Pooled Analysis

Perioperative Blood Transfusion Is a Predictor of Acute and Chronic Renal Function Deterioration after Partial and Radical Nephrectomy for Renal Cell Carcinoma

“…Despite the more frequent diagnosis of RCC in earlier stages and the increasing distribution of minimally invasive procedures in the last 2 decades, perioperative transfusion rates in renal tumor surgery remain high with reported rates of 10–20% [10]. Recently, various studies have examined the influence of PBT on the oncological outcome of patients after surgery for RCC [3]. This study is the first to investigate a possible link of PBT to kidney function after renal tumor surgery.…”

“…Of these observed differences between PBT and non-PBT patients, the presence of a preoperatively impaired renal function was, in addition to PS, tumor stage, distant metastases, and anemia, an independent risk factor to obtain a PBT in the multivariable analysis (HR 2.55, 95% CI 1.46–4.45, p = 0.001). Other authors found that the odds of a PBT was associated with age, gender, PS, tumor stage and localization, surgical volume and experience, open surgery, a preoperative anemia, and cumulative comorbidity scores, but they did not investigate the relationship between a preoperative CKD alone with the risk of applying a PBT [3, 11, 12]. Therefore, our study is the first that reveals patients with a CKD are a priori at risk to obtain a PBT, which represents the first link between a PBT and renal function in our study.…”

“…Despite the high standardization, PN and RN still need to be considered as major surgery, which poses a rather significant risk of perioperative complications [2]. Since acute and delayed hemorrhage are among the most common procedure-related complications, the requirement for perioperative blood transfusion (PBT) is still high and is usually estimated with rates between 10 and 20% in current studies [3]. Recently, PBTs have been evaluated as a potential risk factor for impaired oncological outcome in patients undergoing surgery for different malignancies, including colorectal, bladder, and prostate cancer [4-6].…”

“…Recently, PBTs have been evaluated as a potential risk factor for impaired oncological outcome in patients undergoing surgery for different malignancies, including colorectal, bladder, and prostate cancer [4-6]. Regarding RCC, a recent meta-analysis found a significant association between PBT and disease recurrence and cancer-specific and all-cause mortality for patients undergoing surgery for RCC [3]. To date, the available studies in the field of renal tumor surgery focus exclusively on the oncological outcome, whereas the influence on the functional outcome has not been investigated.…”

Impact of perioperative blood transfusions on clinical outcomes in patients undergoing surgery for major urologic malignancies

“…47 As opposed to these studies, a multicenter study by Park and colleagues found no association between PBT and prognosis in patients with RCC, following propensity score matching analysis. 14 Recently, Arcaniolo and colleagues 48 addressed this debate by conducting a systematic review and pooled However, despite the significant decrease in PBT rate following RP, the risk of bleeding remains a major concern, mainly since intraoperative bleeding can have an effect on perioperative morbidity, primarily, transfusion requirements.…”