Impact of blood transfusion on early outcome of liver resection for colorectal hepatic metastases

Gruttadauria, Salvatore; Chaumet, Maureen Saint Georges; Pagano, Domenico; Marsh, J. Wallis; Bartoccelli, Carlo; Cintorino, Davide; Arcadipane, Antonio; Vizzini, Giovanni; Spada, Marco; Gridelli, Bruno

doi:10.1002/jso.21796

Cited by 43 publications

(35 citation statements)

References 15 publications

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“…In the present study, a significant increase in fluid replacement was observed in patients receiving neo-adjuvant chemotherapy in the matched population. As also observed in the present multivariate analysis, higher intra-operative blood loss is an established risk factor for post-operative morbidity and mortality [15,30,31], so it is reasonable to suppose a role for this factor in determining the increase of morbidity observed in treated subjects of the present study population. Neo-adjuvant chemotherapy can lead to increased intraoperative blood loss that, in turn, could lead to a relative increase in morbidity.…”

Section: Discussionsupporting

confidence: 71%

Safety of hepatic resection for colorectal metastases in the era of neo-adjuvant chemotherapy

Cucchetti

Ercolani

Cescon

et al. 2011

Langenbecks Arch Surg

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Section: Discussionsupporting

confidence: 71%

Safety of hepatic resection for colorectal metastases in the era of neo-adjuvant chemotherapy

Cucchetti

Ercolani

Cescon

et al. 2011

Langenbecks Arch Surg

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“…All identified studies were observational design studies involving a total of 10621 patients. Seven studies were from USA [5, 7, 9, 16, 21, 22, 24], four from Italy [4, 8, 12, 13], three from Japan [3, 14, 18], two from UK [11, 25], two from Germany [20, 23], one from Sweden [2], one from France [6], one from Spain [10], one from Brazil [15], one from China [17], one from Canada [19], and one from the Netherlands [26]. The blood product transfusion rate was highly variable across studies ranging from 13.5% to 91.5%.…”

Section: Resultsmentioning

confidence: 99%

Impact of perioperative blood transfusion on clinical outcomes in patients with colorectal liver metastasis after hepatectomy: a meta-analysis

Lyu

Qiao

et al. 2017

Oncotarget

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BACKGROUNDPerioperative blood transfusion may be associated with negative clinical outcomes in oncological surgery. A meta-analysis of published studies was conducted to evaluate the impact of blood transfusion on short- and long-term outcomes following liver resection of colorectal liver metastasis (CLM).MATERIALS AND METHODSA systematic search was performed to identify relevant articles. Data were pooled for meta-analysis using Review Manager version 5.3.RESULTSTwenty-five observational studies containing 10621 patients were subjected to the analysis. Compared with non-transfused patients, transfused patients experienced higher overall morbidity (odds ratio [OR], 1.98; 95% confidence intervals [CI] =1.49-2.33), more major complications (OR, 2.12; 95% CI =1.26-3.58), higher mortality (OR, 4.13; 95% CI =1.96-8.72), and longer length of hospital stay (weighted mean difference, 4.43; 95% CI =1.15-7.69). Transfusion was associated with reduced overall survival (risk ratio [RR], 1.24, 95% CI =1.11-1.38) and disease-free survival (RR, 1.38, 95% CI=1.23-1.56).CONCLUSIONPerioperative blood transfusion has a detrimental impact on the clinical outcomes of patients undergoing CLM resection.

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“…Evidence of RBCT impact on morbidity pertaining specifically to liver resection remains limited. All studies rely on retrospective data from single centres (24,38,39). The largest such study reported increased morbidity, mortality, and LOS in transfused patients, but dates back to the 1980s and 1990s (24).…”

Section: Discussionmentioning

confidence: 99%

“…The largest such study reported increased morbidity, mortality, and LOS in transfused patients, but dates back to the 1980s and 1990s (24). Two other studies used contemporary data and revealed similar associations between RBCT and morbidity, but were of limited sample size (38,39). The current study represents a unique addition to the literature as it takes into account the uniqueness of liver resection, uses contemporary data, and is the first multi-institutional appraisal of the relationship between RBCT and short-term post-operative outcomes.…”

Section: Discussionmentioning

confidence: 99%

The impact of perioperative blood transfusions on short-term outcomes following hepatectomy

Hallet¹,

Mahar²,

Nathens³

et al. 2018

Hepatobiliary Surg. Nutr.

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Background: Bleeding and need for red blood cell transfusions (RBCT) remain a significant concern with hepatectomy. RBCT carry risk of transfusion-related immunomodulation that may impact post-operative recovery. This study soughs to assess the association between RBCT and post-hepatectomy morbidity. Two exposure groups were created based on RBCT. Primary outcomes were 30-day major morbidity and mortality. Secondary outcomes included 30-day system-specific morbidity and length of stay (LOS). Relative risks (RR) with 95% confidence interval (95% CI) were computed using regression analyses. Sensitivity analyses were conducted to understand how missing data might have impacted the results.Results: A total of 12,180 patients were identified. Of those, 11,712 met inclusion criteria, 2,951 (25.2%) of whom received RBCT. Major morbidity occurred in 14.9% of patients and was strongly associated with RBCT (25.3% vs. 11.3%; P<0.001). Transfused patients had higher rates of 30-day mortality (5.6% vs. 1.0%; P<0.0001). After adjustment for baseline and clinical characteristics, RBCT was independently associated with increased major morbidity (RR 1.80; 95% CI: 1.61-1.99), mortality (RR 3.62; 95% CI: 2.68-4.89), and 1.29 times greater LOS (RR 1.29; 95% CI: 1.25-1.32). Results were robust to a number of sensitivity analyses for missing data.Conclusions: Perioperative RBCT for hepatectomy was independently associated with worse shortterm outcomes and prolonged LOS. These findings further the rationale to focus on minimizing RBCT for hepatectomy, when they can be avoided.

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Impact of blood transfusion on early outcome of liver resection for colorectal hepatic metastases

Cited by 43 publications

References 15 publications

Safety of hepatic resection for colorectal metastases in the era of neo-adjuvant chemotherapy

Safety of hepatic resection for colorectal metastases in the era of neo-adjuvant chemotherapy

Impact of perioperative blood transfusion on clinical outcomes in patients with colorectal liver metastasis after hepatectomy: a meta-analysis

The impact of perioperative blood transfusions on short-term outcomes following hepatectomy

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