title: Blood salvage autotransfusion during transplantation for hepatocarcinoma: does it increase the risk of neoplastic recurrence?
abstract: Impact of intraoperative blood salvage autotransfusion (IBSA) on neoplastic recurrence. during liver transplantations for hepatocellular carcinoma (LT-HCC). Between January 1989 and February 2003, 16 patients received a LT-HCC without IBSA. This group was compared with 31 patients who received the same surgical procedure during the same period, but with IBSA. Data were prospectively collected. All patients had at least a 1-year postoperative follow up. Pairing was made according to the size of the largest nodule. The percentage of recurrence observed in the two groups was similar: 6.4% in the IBSA group vs. 6.3% in the group without IBSA. The median amount of transfused salvage blood was 1558 ml. The differences observed between the two groups concerned the Child score which was A in 58% patients of the IBSA group vs. 80% in the other group; the percentage of severe portal hypertension was 55% in the IBSA group vs. 31%; the median number of packed red blood cell units transfused intraoperatively was 7 in the IBSA group vs. 0, and the median number of frozen fresh plasma units transfused intraoperatively was 11 in the IBSA group vs. 4.5. It appears that IBSA, essentially used during the most haemorrhagic transplantations, could be used in the case of HCC because it does not modify the risk of neoplastic recurrence.
authors.affiliation: Digestive Surgery Department, University Hospital, Rangueil, Toulouse, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Muscari
authors.forename: Bertrand
authors.initials: B
authors.lastname: Suc
authors.forename: Dominique
authors.initials: D
authors.lastname: Vigouroux
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Duffas
authors.forename: Isabelle
authors.initials: I
authors.lastname: Migueres
authors.forename: Anne
authors.initials: A
authors.lastname: Mathieu
authors.forename: Laurence
authors.initials: L
authors.lastname: Lavayssiere
authors.forename: Lionel
authors.initials: L
authors.lastname: Rostaing
authors.forename: Gilles
authors.initials: G
authors.lastname: Fourtanier
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000706:statistics & numerical data; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000601:surgery; D008113:Liver Neoplasms / Q000453:epidemiology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D012307:Risk Factors