Safety and utility of autologous blood transfusion for resection of metastatic liver tumor.
OBJECTIVE
The purpose of this study was to evaluate the safety and efficacy of predeposit autologous blood transfusion for resection of hepatic metastases.


METHODS
We examined stored blood from 25 patients with advanced colorectal or gastric cancer for carcinoembryonic antigen mRNA using reverse-transcriptase-polymerase chain reaction assay to detect cancer cell in the autologous blood. We also retrospectively evaluated no transfusion (A, n = 44), autologous transfusion (B, n = 15), and homologous transfusion groups (C, n = 26) for perioperative liver function and long-term outcome after undergoing resection of liver metastases.


RESULTS
In 5 of 25 patients, carcinoembryonic antigen mRNA was detected immediately after blood donation and after 7 days of storage, but not after 14-21 days of storage. The cumulative 5-year survival rates for groups A, B, and C were not different. However, disease-free survival with colorectal liver metastases was significantly higher in group A than in group C (P = 0.019). Total bilirubin concentrations in group C on the first postoperative day were also significantly higher than group A (P = 0.025).


CONCLUSIONS
Stored autologous blood may contain cancer cells, but these decrease or disappear after storage for more than 7 days. For hepatic resection of metastases, transfusion avoidance yields the optimal outcome.
Obayashi
T
T
Department of Digestive Surgery, Kyoto Prefectural University of Medicine, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602 Japan. taka-yo-@fa2.so-net.ne.jp
Taniguchi
H
H
Mugitani
T
T
Koh
T
T
Kitagawa
K
K
Kunishima
S
S
Yamaguchi
A
A
Yamagishi
H
H
D000368:Aged; D001804:Blood Transfusion, Autologous; D002272:Carcinoembryonic Antigen / Q000097:blood / Q000235:genetics; D015179:Colorectal Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D012333:RNA, Messenger / Q000097:blood; D013274:Stomach Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate
D002272:Carcinoembryonic Antigen; D012333:RNA, Messenger