Influence of Transfusions on Perioperative and Long-Term Outcome in Patients Following Hepatic Resection for Colorectal Metastases

Kooby, David A.; Stockman, J.A.; Ben-Porat, Leah; Gönen, Mithat; Jarnagin, William R.; DeMatteo, Ronald P.; Tuorto, Scott; Wuest, David; Blumgart, Leslie H.; Fong, Yuman

doi:10.1097/01.sla.0000072371.95588.da

Cited by 484 publications

(367 citation statements)

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“…[1][2][3][4][5] Despite many technical advances, intraoperative bleeding remains a problem during liver resection with 30-40% of patients receiving perioperative blood transfusions. [6][7][8] Blood transfusion carries several risks, including transfusion-transmitted viruses, transfusion-related acute lung injury, transfusion-associated circulatory overload, acute hemolytic transfusion reactions, bacterial contamination and severe allergic reactions. 9 In addition, bleeding and blood transfusion are risk factors for postoperative morbidity and in some reports, long-term cancer recurrence.…”

Section: Introductionmentioning

confidence: 99%

Major liver resection, systemic fibrinolytic activity, and the impact of tranexamic acid

Karanicolas

Lin

Tarshis

et al. 2016

HPB

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Section: Introductionmentioning

confidence: 99%

Major liver resection, systemic fibrinolytic activity, and the impact of tranexamic acid

Karanicolas

Lin

Tarshis

et al. 2016

HPB

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“…15 Some investigators have even suggested that hepatectomy itself is an immunosuppressive event that results in significant Kupffer cell and T-cell dysfunction. 16,17 As such, the potential impact of perioperative complications on oncological outcomes after hepatectomy may be particularly important. Our group previously reported on the impact of perioperative complications among patients undergoing surgery for colorectal liver metastasis.…”

Section: Introductionmentioning

confidence: 99%

Impact of complications on long‐term survival after resection of intrahepatic cholangiocarcinoma

Spolverato

Yakoob

Kim

et al. 2015

Cancer

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BACKGROUND:The impact of postoperative complications on the long-term outcomes of patients undergoing surgery for cancer is unclear. The objective of the current study was to define the incidence of complications among patients undergoing surgery for intrahepatic cholangiocarcinoma (ICC) and identify the association between morbidity and long-term outcomes. METHODS: A total of 583 patients undergoing surgery with curative intent for ICC between 1990 and 2013 at 1 of 12 participating institutions were identified. The association between the occurrence and severity of postoperative complications on long-term survival was analyzed. RESULTS: The median age of the patients was 59.9 years and the majority of patients were male (52.3%). A total of 91 patients (15.6%) and 153 patients (26.2%) developed a major and minor postoperative complication, respectively; 18 patients (3.5%) died within 90 days of surgery. Median, 1-year, 3-year, and 5-year recurrence-free survival were 10.0 months, 43.3%, 16.7%, and 11.1%, respectively. Postoperative complications (hazard ratio [HR] CONCLUSIONS: Postoperative complications were found to be independent predictors of worse long-term outcomes. The prevention and management of postoperative complications is crucial to increase both short-term and long-term survival. Cancer 2015;121:2730-9.

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“…2 During hepatic surgery, intraoperative hemorrhage is common, often necessitating blood transfusion, the latter being suggested as a predictor of postoperative outcome and poor prognosis. 3,4 Therefore, approaches to control intraoperative bleeding are presently applied worldwide and include vascular clamping methods. 5,6 However, such measures cause hepatic ischemia/reperfusion (I/R) to the liver tissue, which may contribute to postoperative liver failure.…”

mentioning

confidence: 99%

Ischemia/Reperfusion Accelerates the Outgrowth of Hepatic Micrometastases in a Highly Standardized Murine Model *

Bilt¹,

Kranenburg²,

Nijkamp³

et al. 2005

Hepatology

159

131

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Mortality in colorectal cancer is associated with the development of liver metastases. Surgical removal of these tumors is the only hope for cure, but recurrence is common. During liver surgery, ischemia/reperfusion (I/R) often occurs as a result of hemorrhage or vascular clamping. Although the adverse effects of I/R on postoperative liver function are well documented, the influence of I/R on the outgrowth of residual micrometastases is unknown. We used a highly standardized mouse model of partial hepatic I/R to study the effects of I/R on the outgrowth of preestablished colorectal micrometastases. Five days following intrasplenic injection of C26 colon carcinoma cells, the vascular structures of the left lobe were clamped for 45 minutes under hemodynamically stable conditions. Tissue glutathione, plasma liver enzymes, hepatocellular necrosis, and tumor growth were assessed over time. I/R caused oxidative stress and early liver tissue damage. The outgrowth of micrometastases in occluded liver lobes was accelerated five-to sixfold compared with nonoccluded lobes and was associated with areas of necrotic liver tissue surrounded by inflammatory cells and apoptotic hepatocytes. Accelerated tumor growth and tissue necrosis were completely prevented by occluding blood flow intermittently. In contrast, ischemic preconditioning or treatment with the antioxidants ␣-tocopherol or ascorbic acid failed to protect against late tissue necrosis and tumor growth, although early hepatocellular damage was largely prevented by these methods. In conclusion, I/R is a strong stimulus of recurrent intrahepatic tumor growth. Measures to prevent I/R-induced late tissue necrosis cross-protect against this phenomenon. (HEPATOLOGY 2005;42:165-175.)

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Influence of Transfusions on Perioperative and Long-Term Outcome in Patients Following Hepatic Resection for Colorectal Metastases

Abstract: Perioperative blood transfusion is a risk factor for poor outcome after liver resection. Blood conservation methods should be used to avoid transfusion, especially in patents currently requiring limited amounts of transfused blood products.

Cited by 484 publications

References 64 publications

Major liver resection, systemic fibrinolytic activity, and the impact of tranexamic acid

Major liver resection, systemic fibrinolytic activity, and the impact of tranexamic acid

Impact of complications on long‐term survival after resection of intrahepatic cholangiocarcinoma

Ischemia/Reperfusion Accelerates the Outgrowth of Hepatic Micrometastases in a Highly Standardized Murine Model *

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