Transfusion Timing and Postoperative Septic Complications After Gastric Cancer Surgery

Influence of Transfusions on Perioperative and Long-Term Outcome in Patients Following Hepatic Resection for Colorectal Metastases

“…An association between transfusion and postoperative complications has been shown both in preclinical models 59,60 and in clinical studies of other cancer types. [61][62][63][64][65] In a prospective analysis of 740 patients undergoing resection for colorectal cancer, 19% of 288 nontransfused and 31% of 452 transfused patients developed postoperative infectious complications (P Ͻ .001). 65 In a recent review of 254 consecutive elective liver resections (all diseases), Alfieri et al found a significant association between administration of blood products and development of complications.…”

“…Studies in other cancer types have suggested that use of autologous transfusion limits the requirement for allogeneic exposure and can reduce the incidence of complications. 39,63 Since hepatectomy is an immunosuppressive event that results in significant Kupffer cell and T-cell dysfunction, 73 small benefits produced by autologous transfusion may be undetectable with a sample size of only 86 patients so treated. Certainly, the current data should not be used to abandon autologous blood donation.…”

Risk factors for operative morbidity and mortality in gastric cancer patients undergoing total gastrectomy

“…Clinical evidence of a relationship between perioperative transfusion and postoperative septic complications has been reported in some studies of gastric cancer [17][18][19][20] . Although the exact mechanism of immunosuppression is still to be elucidated, reduced tumor necrosis factor-α levels, interleukin 10 (IL-10) induction, impair ment of natural killer cells, increases in certain other cytokines, complement activation, decreased macrophage function, decreased CD4/CD8 ratio, and decreased IL-2 secretion are all involved [21][22][23] .…”

Fatores preditivos da transfusão de concentrado de hemácias em pacientes submetidos a cirurgias eletivas do aparelho digestivo: uma análise interinstitucional

“…(4,13,14) Interestingly, publications have shown an association between RBCT and management of gastric tumors with poor prognosis and shorter survival different to the practices adopted by professionals during surgery in this study. (17,18) Even with anemia being an indication for transfusion in the preoperative period and reports of postoperative bleeding, transfusions in the vast majority of the patients of this study were not justified. Furthermore, there was no significant correlation between the hemoglobin and hematocrit levels and transfusions.…”

“…(16) Similarly, a study involving 179 patients submitted to gastric surgery for tumors demonstrated, by univariate analysis, that a large volume of blood was transfused and that the transfusion practice was associated with a worse prognosis. (17) Another study that examined the impact of RBCT on 154 patients who were submitted to radical gastrectomy showed, by multivariate analysis, that transfusion was directly associated to reduced survival. (18) The use of recombinant human erythropoietin associated with iron supplementation may significantly reduce the need for perioperative RBCT, by elevating the hematocrit in anemic patients suffering from gastrointestinal tumors.…”