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Efficacy of Autotransfusion in Hepatectomy for Hepatocellular Carcinoma

Efficacy of Autotransfusion in Hepatectomy for Hepatocellular Carcinoma Abstract Purpose: Although autotransfusion is used in a wide variety of surgical procedures, it is largely unexplored for use in oncologic operations. This study evaluates the impact of autotransfusion in hepatectomy for hepatocellular carcinoma. Patients and Methods: Fifty-four patients with hepatocellular carcinoma underwent hepatectomy by receiving autologous blood transfusion (group 1). Fifty patients receiving homologous blood without any autologous blood were matched for comparison (group 2). Results: No statistical differences were found between group 1 and group 2 patients in cumulative recurrence rates (62.8% vs 67.3%, respectively) or cumulative survival rates (61.9% vs 52.8%). Autologous transfusion reduced the mean volume of homologous blood used (814 mL vs 3466 mL). The mean postoperative hemoglobin level, platelet count, prothrombin time, and partial thromboplastin time were comparable between groups. Conclusions: Autotransfusion is a safe and effective procedure in patients with hepatocellular carcinoma undergoing hepatectomy.(Arch Surg. 1993;128:1065-1069) References 1. Hallet JW, Popovsky M, llstrup D. Minimizing blood transfusions during abdominal aortic surgery: recent advances in rapid autotransfusion . J Vasc Surg . 1987;5:601-606.Crossref 2. Dzik WH, Jenkins R. Use of intraoperative blood salvage during orthotopic liver transplantation . Arch Surg . 1985;120:946-948.Crossref 3. Williamson KR, Taswell HF. Intraoperative blood salvage: a review . Transfusion . 1991;31:662-675.Crossref 4. Council on Scientific Affairs. Autologous blood transfusions . JAMA . 1986:256: 2378-2380.Crossref 5. Popovsky MA. The role of autologous transfusion in surgery and the emergency room . In: Garner RJ, Silvergleid AJ, eds. Autologous and Directed Blood Programs . Arlington, Va: American Association of Blood Banks; 1987:47-64. 6. Klimberg I, Sirois R, Wajsman Z, Baker J. Intraoperative autotransfusion in urologic oncology . Arch Surg . 1986;121:1326-1329.Crossref 7. Marshall FF, Reitz BA. Supradiaphragmatic renal cell carcinoma tumor thrombus . J Urol . 1985;133:266-268. 8. Liver Cancer Study Group of Japan. The general rules for the clinical and pathological study of primary liver cancer . Jpn J Surg . 1989;19:98-129.Crossref 9. Yamanaka N, Okamoto E. Criteria of curability in the resection therapy for hepatocellular carcinoma . J Jpn Soc Cancer Ther . 1989;24:72-79. 10. Gilche RO, Belcher L. Preoperative autologous blood donation programs . In: Garner RJ, Silvergleid AJ, eds. Autologous and Directed Blood Programs . Arlington, Va: American Association of Blood Banks; 1987:15-29. 11. Hasegawa H. Procedures of Hepatectomy and Patient Care . Tokyo, Japan: IgakuShoin Ltd; 1983:137-151. 12. Curran JW, Lawrence DN, Jaffe H, et al. Acquired immunodeficiency syndrome (AIDS) associated with transfusion . N Engl J Med . 1984;310:69-75.Crossref 13. Gilcher RO. Adverse effects of transfusion mediated by infectious agents . Plasma Ther Transfus Technol . 1985;6:81-93. 14. Gallo RC. The first human retrovirus . Sci Am . 1986;255:88-98.Crossref 15. Opelz G, Terasaki PI. Improvement of kidney graft survival with increased numbers of blood transfusion . N Engl J Med . 1978;299:799-804.Crossref 16. Little AG, Wu HS, Ferguson MK, et al. Perioperative blood transfusion adversely affects prognosis of patients with stage I non-small-cell lung cancer . Am J Surg . 1990;160:630-633.Crossref 17. Crowson MC, Halissey MT, Kif RS, Kingston RD, Fielding JL. Blood transfusion in colorectal cancer . Br J Surg . 1989;76:522-523.Crossref 18. Crowe JP, Gordon NH, Fry DE, Shuck JM, Hubay CA. Breast cancer survival and perioperative blood transfusion . Surgery . 1989;106:836-841. 19. Yaw PB, Sentany M, Link WJ, et al. Tumor cells carried through autotransfusion: contraindication to intraoperative blood recovery? JAMA . 1975;231:480-491.Crossref 20. Salsbury AJ. The significance of the circulating cancer cell . Cancer Treat Rev . 1975;2:55-72.Crossref 21. Griffith JD, McKinna JA, Rawbotham HD, et al. Carcinoma of the colon and rectum: circulating malignant cells and five year survival . Cancer . 1973:31: 226-236.Crossref 22. Belghiti J, Panis Y, Farges O, Benhamou JP, Fekete F. Intrahepatic recurrence after resection of hepatocellular carcinoma complicating cirrhosis . Ann Surg . 1991;214:114-117.Crossref 23. Yamanaka N, Okamoto E, Toyosaka A, et al. Prognostic factors after hepatectomy for hepatocellular carcinomas . Cancer . 1990:65:1104-1110.Crossref 24. Fujimoto J, Okamoto E, Yamanaka N, Mitsunobu M, Toyosaka A. Flow cytometric DNA analysis of hepatocellular carcinoma . Cancer . 1991;67:939-944.Crossref 25. Braunstein AH, Oberman HA. Transfusion of plasma components . Transfusion . 1984;24:281-286.Crossref 26. The Office of Medical Applications of Research, National Institute of Health. Fresh-frozen plasma: indications and risks . JAMA . 1985;253:551-553.Crossref 27. Fujimoto J, Okamoto E, Yamanaka N. Post transfusion hepatitis in hepatectomized patients . J Jpn Gastrointest Surg . 1989;22:774-778.Crossref 28. McClelland DBL. Human albumin solutions . BMJ . 1990;300:35-37.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1993.01420210129021
Publisher site
See Article on Publisher Site

Abstract

Abstract Purpose: Although autotransfusion is used in a wide variety of surgical procedures, it is largely unexplored for use in oncologic operations. This study evaluates the impact of autotransfusion in hepatectomy for hepatocellular carcinoma. Patients and Methods: Fifty-four patients with hepatocellular carcinoma underwent hepatectomy by receiving autologous blood transfusion (group 1). Fifty patients receiving homologous blood without any autologous blood were matched for comparison (group 2). Results: No statistical differences were found between group 1 and group 2 patients in cumulative recurrence rates (62.8% vs 67.3%, respectively) or cumulative survival rates (61.9% vs 52.8%). Autologous transfusion reduced the mean volume of homologous blood used (814 mL vs 3466 mL). The mean postoperative hemoglobin level, platelet count, prothrombin time, and partial thromboplastin time were comparable between groups. Conclusions: Autotransfusion is a safe and effective procedure in patients with hepatocellular carcinoma undergoing hepatectomy.(Arch Surg. 1993;128:1065-1069) References 1. Hallet JW, Popovsky M, llstrup D. Minimizing blood transfusions during abdominal aortic surgery: recent advances in rapid autotransfusion . J Vasc Surg . 1987;5:601-606.Crossref 2. Dzik WH, Jenkins R. Use of intraoperative blood salvage during orthotopic liver transplantation . Arch Surg . 1985;120:946-948.Crossref 3. Williamson KR, Taswell HF. Intraoperative blood salvage: a review . Transfusion . 1991;31:662-675.Crossref 4. Council on Scientific Affairs. Autologous blood transfusions . JAMA . 1986:256: 2378-2380.Crossref 5. Popovsky MA. The role of autologous transfusion in surgery and the emergency room . In: Garner RJ, Silvergleid AJ, eds. Autologous and Directed Blood Programs . Arlington, Va: American Association of Blood Banks; 1987:47-64. 6. Klimberg I, Sirois R, Wajsman Z, Baker J. Intraoperative autotransfusion in urologic oncology . Arch Surg . 1986;121:1326-1329.Crossref 7. Marshall FF, Reitz BA. Supradiaphragmatic renal cell carcinoma tumor thrombus . J Urol . 1985;133:266-268. 8. Liver Cancer Study Group of Japan. The general rules for the clinical and pathological study of primary liver cancer . Jpn J Surg . 1989;19:98-129.Crossref 9. Yamanaka N, Okamoto E. Criteria of curability in the resection therapy for hepatocellular carcinoma . J Jpn Soc Cancer Ther . 1989;24:72-79. 10. Gilche RO, Belcher L. Preoperative autologous blood donation programs . In: Garner RJ, Silvergleid AJ, eds. Autologous and Directed Blood Programs . Arlington, Va: American Association of Blood Banks; 1987:15-29. 11. Hasegawa H. Procedures of Hepatectomy and Patient Care . Tokyo, Japan: IgakuShoin Ltd; 1983:137-151. 12. Curran JW, Lawrence DN, Jaffe H, et al. Acquired immunodeficiency syndrome (AIDS) associated with transfusion . N Engl J Med . 1984;310:69-75.Crossref 13. Gilcher RO. Adverse effects of transfusion mediated by infectious agents . Plasma Ther Transfus Technol . 1985;6:81-93. 14. Gallo RC. The first human retrovirus . Sci Am . 1986;255:88-98.Crossref 15. Opelz G, Terasaki PI. Improvement of kidney graft survival with increased numbers of blood transfusion . N Engl J Med . 1978;299:799-804.Crossref 16. Little AG, Wu HS, Ferguson MK, et al. Perioperative blood transfusion adversely affects prognosis of patients with stage I non-small-cell lung cancer . Am J Surg . 1990;160:630-633.Crossref 17. Crowson MC, Halissey MT, Kif RS, Kingston RD, Fielding JL. Blood transfusion in colorectal cancer . Br J Surg . 1989;76:522-523.Crossref 18. Crowe JP, Gordon NH, Fry DE, Shuck JM, Hubay CA. Breast cancer survival and perioperative blood transfusion . Surgery . 1989;106:836-841. 19. Yaw PB, Sentany M, Link WJ, et al. Tumor cells carried through autotransfusion: contraindication to intraoperative blood recovery? JAMA . 1975;231:480-491.Crossref 20. Salsbury AJ. The significance of the circulating cancer cell . Cancer Treat Rev . 1975;2:55-72.Crossref 21. Griffith JD, McKinna JA, Rawbotham HD, et al. Carcinoma of the colon and rectum: circulating malignant cells and five year survival . Cancer . 1973:31: 226-236.Crossref 22. Belghiti J, Panis Y, Farges O, Benhamou JP, Fekete F. Intrahepatic recurrence after resection of hepatocellular carcinoma complicating cirrhosis . Ann Surg . 1991;214:114-117.Crossref 23. Yamanaka N, Okamoto E, Toyosaka A, et al. Prognostic factors after hepatectomy for hepatocellular carcinomas . Cancer . 1990:65:1104-1110.Crossref 24. Fujimoto J, Okamoto E, Yamanaka N, Mitsunobu M, Toyosaka A. Flow cytometric DNA analysis of hepatocellular carcinoma . Cancer . 1991;67:939-944.Crossref 25. Braunstein AH, Oberman HA. Transfusion of plasma components . Transfusion . 1984;24:281-286.Crossref 26. The Office of Medical Applications of Research, National Institute of Health. Fresh-frozen plasma: indications and risks . JAMA . 1985;253:551-553.Crossref 27. Fujimoto J, Okamoto E, Yamanaka N. Post transfusion hepatitis in hepatectomized patients . J Jpn Gastrointest Surg . 1989;22:774-778.Crossref 28. McClelland DBL. Human albumin solutions . BMJ . 1990;300:35-37.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1993

References