Autologous blood transfusion for hepatectomy in patients with cirrhosis and hepatocellular carcinoma: use of recombinant human erythropoietin.
BACKGROUND
We evaluated the benefit of autologous blood transfusion and the effect of recombinant human erythropoietin (rh-EPO) on preoperative autologous blood donation for hepatectomy in patients with cirrhosis.


METHODS
Forty-two patients with cirrhosis and hepatocellular carcinoma underwent hepatectomy, 21 of whom (group A) donated autologous blood before operation. Eleven of these patients (group A1) were administered rh-EPO before operation, and ten patients (group A2) were untreated. Twenty-one patients (group B) did not donate autologous blood.


RESULTS
The frequency of homologous blood transfusion was 24% in group A and 62% in group B (p < 0.05). Preoperative erythropoiesis increased markedly in group A1, and postoperative erythropoietin production was not suppressed in this group. Postoperative hematocrits recovered significantly more rapidly in patients transfused with only autologous blood. Postoperative serum total bilirubin concentrations were significantly higher in patients with transfused homologous blood.


CONCLUSIONS
Autologous blood transfusion yields clinically superior results for hepatectomy in patients with cirrhosis when compared with homologous transfusion. Preoperative rh-EPO administration minimizes presurgical decreases in hematocrit caused by autologous blood donation.
Kajikawa
M
M
Department of Surgery II, School of Medicine, Nagoya University, Japan.
Nonami
T
T
Kurokawa
T
T
Hashimoto
S
S
Harada
A
A
Nakao
A
A
Takagi
H
H
D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000097:blood; D001804:Blood Transfusion, Autologous; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery / Q000628:therapy*; D004921:Erythropoietin / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006400:Hematocrit; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery / Q000628:therapy*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011994:Recombinant Proteins / Q000627:therapeutic use
D011994:Recombinant Proteins; D004921:Erythropoietin; D001663:Bilirubin