Assessment of blood-products use as predictor of pulmonary complications and surgical-site infection after hepatectomy for hepatocellular carcinoma.
BACKGROUND
In perioperative management after hepatectomy, some patients require fresh frozen plasma (FFP) to treat coagulopathy associated with blood loss. However, several studies have suggested a correlation between blood products and pulmonary complications or surgical-site infection (SSI).


METHODS
The subjects were 99 patients who underwent hepatectomy for hepatocellular carcinoma without plasma exchange for postoperative liver failure in the Department of Surgery, Jikei University Hospital, between January 2000 and December 2006. We investigated the association of 16 factors including age; gender; preoperative ICG(R15); type of resection; concomitant resection of other digestive organs; duration of operation; blood loss; hepatitis virus status; postoperative minimum platelet count, maximum serum total bilirubin (max T-Bil), minimum serum albumin, or minimum prothrombin time; and the dose of red-blood-cell concentration (RC), FFP, platelet concentration, or albumin given in relation to postoperative pulmonary complications and SSI.


RESULTS
In univariate analysis, pulmonary complications were correlated with gender (P = 0.012), max T-Bil (P = 0.043), dose of RC given (P = 0.007), dose of FFP given (P < 0.001), and dose of albumin given (P < 0.001). In multivariate analysis, pulmonary complications were correlated with FFP given (P = 0.031) and albumin given (P = 0.020), while the incidence of SSI was not correlated with any factors.


CONCLUSIONS
Excessive FFP and albumin administration may cause pulmonary complications after hepatectomy.
Shiba
Hiroaki
H
Department of Surgery, Jikei University School of Medicine, Minato, Tokyo, Japan. hs0817@jikei.ac.jp
Ishii
Yuji
Y
Ishida
Yuichi
Y
Wakiyama
Shigeki
S
Sakamoto
Taro
T
Ito
Ryusuke
R
Gocho
Takeshi
T
Uwagawa
Tadashi
T
Hirohara
Shoichi
S
Kita
Yoshiaki
Y
Misawa
Takeyuki
T
Yanaga
Katsuhiko
K
D000368:Aged; D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D016015:Logistic Models; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010949:Plasma; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control