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


CONCLUSIONS
In patients with underlying liver disease, maintaining CVP at a level below 5 cm H2O during parenchymal transection to reduce blood loss is more important than reserving autologous blood before the operation.
Itamoto
T
T
Department of Surgery II, Hiroshima University Faculty of Medicine, 1-2-3, Kasumi, Minami-Ku, Hiroshima 734-8551, Japan. titamoto@mua.biglobe.ne.jp
Katayama
K
K
Nakahara
H
H
Tashiro
H
H
Asahara
T
T
D000328:Adult; D000368:Aged; D001804:Blood Transfusion, Autologous / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008107:Liver Diseases / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011300:Preoperative Care / Q000379:methods; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors