title: Effect of blood transfusion on outcome after pancreaticoduodenectomy for exocrine tumour of the pancreas.
abstract: BACKGROUND
  Blood transfusion is thought to have an immunosuppressive effect. The aims of this study were to examine survival in patients with pancreatic cancer receiving blood transfusion in association with pancreaticoduodenectomy, and to define preoperative risk factors for subsequent transfusion.
  
  
  METHODS
  A retrospective review was performed of a prospective database of patients with exocrine tumours of the head of the pancreas who had undergone pancreaticoduodenectomy between 1998 and 2003. Clinical data, transfusion records and preoperative laboratory values were recorded.
  
  
  RESULTS
  A total of 294 patients underwent pancreaticoduodenectomy for exocrine tumours in the pancreatic head. Of these, 140 (47.6 per cent) received a blood transfusion. Their median survival was 18 months, compared with 24 months for those who did not have a transfusion (P = 0.036). Postoperative transfusion, margin status and node stage were independent predictors of survival. Age and preoperative total bilirubin and haemoglobin levels were the only preoperative factors that correlated with transfusion.
  
  
  CONCLUSIONS
  In patients with exocrine tumours of the pancreas, blood transfusion should be avoided when possible. Preoperative risk factors can identify patients who are likely to require transfusion and would therefore benefit most from blood conservation methods.
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York 10021, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Yeh
authors.forename: M
authors.initials: M
authors.lastname: Gonen
authors.forename: J S
authors.initials: JS
authors.lastname: Tomlinson
authors.forename: K
authors.initials: K
authors.lastname: Idrees
authors.forename: M F
authors.initials: MF
authors.lastname: Brennan
authors.forename: Y
authors.initials: Y
authors.lastname: Fong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D016063:Blood Loss, Surgical / Q000503:physiopathology*; D017707:Erythrocyte Transfusion / Q000401:mortality*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality*; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D006454:Hemoglobins; D001663:Bilirubin