Perioperative Allogenenic Blood Transfusion Is Associated with Worse Clinical Outcomes for Hepatocellular Carcinoma: A Meta-Analysis

Abstract

Background and ObjectiveThe 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.MethodsRelevant 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 I2 test. Publication bias was evaluated by funnel plots, Egger′s and Begg’s test.ResultsA 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).ConclusionsThe 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.

Clinical Practice of Blood Transfusion in Orthotopic Organ Transplantation: A Single Institution Experience

“…Recent studies had demonstrated that peri-operative allogeneic blood transfusion had an adverse effect on patients with surgical intervention in various malignancies (Liu et al, 2013;Meng et al, 2013;Ramos et al, 2003;Sugita et al, 2008;Wang et al, 2015). Some of these investigations further indicated that peri-operative transfusion of RBC product, rather than post-operative, was highly associated with prolonged hospital stay as well as increased morbidity and mortality (Ramos et al, 2003;Sugita et al, 2008).…”

Perioperative Blood Transfusion Promotes Worse Outcomes of Bladder Cancer after Radical Cystectomy: A Systematic Review and Meta-Analysis

“…A previous meta-analysis performed by Liu et al [11] demonstrated that allogeneic blood transfusion (ABT) was associated with adverse clinical outcomes for hepatocellular carcinoma patients undergoing surgery, including increased death, recurrence and complications. PBT in patients with bladder cancer was associated with increased morbidity and mortality after RC in several observational studies [12, 13], but other studies [14, 15] did not show this association in multivariable analysis.…”

Intraoperative cell salvage with autologous transfusion in elective right or repeat hepatectomy: a propensity-score–matched case–control analysis

“…Reported risk factors for blood transfusion include preoperative anemia (hemoglobin level < 125 g/L), extrahepatic procedure, caval exposure, major hepatectomy, tumour diameter, thrombopenia, cirrhosis and repeat liver resection. 4,6,7 It has been shown that perioperative allogeneic blood transfusion is a risk factor for complications and death 2,3,8,9 and may reduce disease-free survival after resection of hepatocellular carcinoma 10 and colorectal liver metastases. 11,12 Consequently, a reduction of the allogeneic blood transfusion rate would be welcome.…”