title: Association between Allogeneic or Autologous Blood Transfusion and Survival in Patients after Radical Prostatectomy: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  A number of studies have investigated the effect of perioperative blood transfusion (PBT) for patients after radical prostatectomy (RP), with some reporting conflicting results. A systematic review of the literature and a meta-analysis were conducted to explore the association between PBT (autologous or allogeneic) and biochemical recurrence-free survival (BRFS), overall survival (OS) and cancer-specific survival (CSS) in patients undergoing RP.
  
  
  METHODS
  The PubMed, Medline, Cochrane Library, and Embase databases were searched for published controlled clinical studies on perioperative allogeneic or autologous blood transfusion (BT) and patient survival after RP. STATA software version 12.0 was used for data analysis. We used hazard ratios (HRs) and 95% confidence intervals (CIs) to test the correlation between BT and patient survival after RP.
  
  
  RESULTS
  Data from a total of 26,698 patients in ten published studies were included in the meta-analysis. The meta-analysis results showed that autologous BT was not associated with BRFS (HR: 1.06; 95% CI: 0.96-1.18; Z = 1.17; P = 0.24), OS (HR: 0.86; 95% CI: 0.71-1.04; Z = 1.58; P = 0.11), or CSS (HR: 0.98; 95% CI: 0.49-1.96; Z = 0.05; P = 0.96). Allogeneic BT exhibited a significant association with worse BRFS (HR: 1.09; 95% CI: 1.01-1.16; Z = 2.37; P = 0.02), OS (HR: 1.43; 95% CI: 1.24-1.64; Z = 4.95; P<0.01) and CSS (HR: 1.74; 95% CI: 1.18-2.56; Z = 2.81; P = 0.005).
  
  
  CONCLUSIONS
  Our data showed an association between allogeneic BT and reduced BRFS, OS and CSS in patients after RP. These findings indicate that perioperative blood conservation strategies are important for decreasing the allogeneic BT rate.
authors.affiliation: Department of Laboratory Medicine, The First Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China.
authors.forename: Su-Liang
authors.initials: SL
authors.lastname: Li
authors.affiliation: Department of Laboratory Medicine, The First Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Ye
authors.affiliation: Department of Blood Transfusion, The First Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China.
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Yuan
mesh_terms: D001804:Blood Transfusion, Autologous; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery / Q000628:therapy*; D017594:Publication Bias; D014184:Transplantation, Homologous; D016896:Treatment Outcome