title: Perioperative allogenenic blood transfusion is associated with worse clinical outcomes for hepatocellular carcinoma: a meta-analysis.
abstract: OBJECTIVE
  The impact of perioperative allogenenic blood transfusion (ABT) on clinical outcomes for hepatocellular carcinoma (HCC) is conflicting and unclear. The aim of this meta-analysis is to evaluate the association between ABT and HCC clinical outcomes. Outcomes evaluated were all-cause death, tumor recurrence and postoperative complications.
  
  
  METHODS
  Relevant articles were identified through MEDLINE search (up to November 2012). Meta-analyses were performed by using the fixed or random effect models. Study heterogeneity was assessed by Q-test and I(2) test. Publication bias was evaluated by funnel plots, Egger's and Begg's test.
  
  
  RESULTS
  A total of 5635 cases from 22 studies finally met our inclusion criteria. Meta-analysis indicated HCC patients with ABT had an increased risk of all-cause death at 3 and 5 years after surgery (respectively: OR = 1.92, 95% CI, 1.61-2.29,P<0.001; OR = 1.60, 95% CI, 1.47-1.73,P<0.001 ) compared with those without ABT. The risk of tumor recurrence was significantly higher for ABT cases at 1, 3 and 5 years (respectively: OR = 1.70, 95% CI, 1.38-2.10, P<0.001; OR = 1.22, 95% CI, 1.08-1.38, P<0.001; OR = 1.16, 95% CI, 1.08-1.24, P<0.001). The HCC cases with ABT significantly increased postoperative complications occurrence compared with non-ABT cases (OR = 1.78,95% CI, 1.34-2.37, P<0.001).
  
  
  CONCLUSIONS
  The findings from the current meta-analysis demonstrated that ABT was associated with adverse clinical outcomes for HCC patients undergoing surgery, including increased death, recurrence and complications. Therefore, ABT should not be performed if possible.
authors.affiliation: Department of Surgery, The Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu Province, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Wang
authors.forename: Songqi
authors.initials: S
authors.lastname: Jiang
authors.forename: Bingfeng
authors.initials: B
authors.lastname: Shao
authors.forename: Jibing
authors.initials: J
authors.lastname: Liu
authors.forename: Suqing
authors.initials: S
authors.lastname: Zhang
authors.forename: Yilong
authors.initials: Y
authors.lastname: Zhou
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhou
authors.forename: Yixin
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000368:Aged; D064591:Allografts; D001803:Blood Transfusion; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D000075202:Contraindications; D016206:Databases, Bibliographic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D012008:Recurrence; D016019:Survival Analysis; D016896:Treatment Outcome