Autologous blood storage before hepatectomy for hepatocellular carcinoma.
OBJECTIVE
Perioperative homologous blood transfusion (HBT) has been reported to be a significant prognostic factor for recurrence in hepatocellular carcinoma (HCC) patients after hepatectomy. Autologous blood storage (ABS) has been used to avoid perioperative HBT. The aim of this study was to evaluate the benefit of ABS before the surgery in HCC patients.


METHODS
We retrospectively analyzed 196 patients undergoing hepatectomy for HCC between January 1991 and December 2000. ABS was employed in 113 patients (ABS group), and the remaining 83 patients underwent hepatectomy without ABS (non-ABS group).


RESULTS
The overall survival rates in patients who required HBT were significantly lower than in patients operated without HBT (P=0.0001). The need for HBT was significantly less frequent in the ABS group (43 of 113, 38.1%) than in the non-ABS group (51 of 83, 61.4%) (P=0.0012). In multivariate analysis, HBT and multiple HCCs were found to independently affect the overall survival. The differences of overall survival rates between the ABS group and the non-ABS group were not statistically significant (P=0.1063).


CONCLUSIONS
ABS significantly reduced the HBT requirement in HCC patients undergoing hepatectomy. Although perioperative HBT adversely affected the overall survival in HCC patients, ABS was not significantly influential on survival.
Kato
Koichi
K
Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Japan. katokon@med.nagoya-u.ac.jp
Nomoto
Shuji
S
Sugimoto
Hiroyuki
H
Kanazumi
Naohito
N
Takeda
Shin
S
Nakao
Akimasa
A
D000368:Aged; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome