Preoperative predictors of blood transfusion in liver resection for tumor

Mariette, D; Smadja, Claude; Naveau, Sylvie; Borgonovo, Giacomo; Vons, C.; Franco, Dominique

doi:10.1016/s0002-9610(96)00400-x

Cited by 48 publications

(48 citation statements)

References 9 publications

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“…Resection of one segment sometimes involves a similar or even larger transection surface area than that in hemihepatectomy; minor hepatectomy is sometimes technically more difficult than hemihepatectomy and may therefore not be a lesser procedure. Univariate analyses in the present study revealed that blood loss and the need for transfusion were influenced by almost the same factors as those reported by others 2,22,26,27 . Some studies 21,28,29 have shown that maintenance of a low CVP is effective in reducing blood loss in hepatectomy.…”

Section: Discussionsupporting

confidence: 88%

“…The size of the resected tumour 2 , extent of hepatectomy 2,22,26,27 and presence of underlying liver disease 18 have been correlated with blood loss and transfusion requirement. Mariette et al 22 demonstrated that age was significantly associated with the need for transfusion because elderly patients have poor tolerance for anaemia.…”

Section: Discussionmentioning

confidence: 99%

“…Mariette et al 22 demonstrated that age was significantly associated with the need for transfusion because elderly patients have poor tolerance for anaemia. Gozzetti et al 17 reported that serum albumin and bilirubin levels were significantly correlated with the need for blood transfusion during resection for HCC arising in the cirrhotic liver.…”

Section: Discussionmentioning

confidence: 99%

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

Itamoto

Katayama

Nakahara

et al. 2003

British Journal of Surgery

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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.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Itamoto

Katayama

Nakahara

et al. 2003

British Journal of Surgery

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“…In addition to this finding, we also observed that the size of tumor and blood transfusion were predictors of major postoperative complications. Blood transfusion has long been associated with tumor recurrence (20,23) and also with morbidity and mortality (7,11,14,28) . KOOBY et al (15) revealed that perioperative blood transfusion is a risk factor for poor outcome after liver resection.…”

Section: Discussionmentioning

confidence: 99%

Liver resection: 10-year experience from a single Institution

Coelho

Claus

Machuca

et al. 2004

Arq. Gastroenterol.

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BACKGROUND: Liver resection constitutes the main treatment of most liver primary neoplasms and selected cases of metastatic tumors. However, this procedure is associated with significant morbidity and mortality rates. AIM: To analyze our experience with liver resections over a period of 10 years to determine the morbidity, mortality and risk factors of hepatectomy. PATIENTS AND METHODS: Retrospective review of medical records of patients who underwent liver resection from January 1994 to March 2003. RESULTS: Eighty-three (41 women and 42 men) patients underwent liver resection during the study period, with a mean age of 52.7 years (range 13-82 years). Metastatic colorectal carcinoma and hepatocellular carcinoma were the main indications for hepatic resection, with 36 and 19 patients, respectively. Extended and major resections were performed in 20.4% and 40.9% of the patients, respectively. Blood transfusion was needed in 38.5% of the operations. Overall morbidity was 44.5%. Life-threatening complications occurred in 22.8% of cases and the most common were pneumonia, hepatic failure, intraabdominal collection and intraabdominal bleeding. Among minor complications (30%), the most common were biliary leakage and pleural effusion. Size of the tumor and blood transfusion were associated with major complications (P = 0.0185 and P = 0.0141, respectively). Operative mortality was 8.4% and risk factors related to mortality were increased age and use of vascular exclusion (P = 0.0395 and P = 0.0404, respectively). Median hospital stay was 6.7 days. CONCLUSION: Liver resections can be performed with low mortality and acceptable morbidity rates. Blood transfusion may be reduced by employing meticulous technique and, whenever indicated, vascular exclusion.

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“…In most cases, less than 500 mL blood is lost and transfusion is necessary in less than 20% of patients [13,14]. It can also be predicted by using clinical scores [15]. As the patient's haemodynamics do not usually change during surgery, intraoperative monitoring can be minimal.…”

Section: Liver Surgery Has Become Simplermentioning

confidence: 99%