Influence of transfusions on perioperative and long-term outcome in patients following hepatic resection for colorectal metastases

• Published in: Annals of surgery 2003-06, Vol.237 (6), p.860-870
• Main Authors: KOOBY, David A, STOCKMAN, Jennifer, BOLTON, John S, CHOTI, Michael A, CLARY, Bryan, BAISDEN, Clinton E, BEN-PORAT, Leah, GONEN, Mithat, JARNAGIN, William R, DEMATTEO, Ronald P, TUORTO, Scott, WUEST, David, BLUMGART, Leslie H, YUMAN FONG
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Blood Transfusion; Colorectal Neoplasms - pathology; Female; Hepatectomy; Humans; Length of Stay; Liver Neoplasms - mortality; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Male; Medical sciences; Middle Aged; Multivariate Analysis; Risk Factors; Scientific Papers of the Southern Surgical Association; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survival Analysis; Treatment Outcome
• ISSN: 0003-4932; 1528-1140
• DOI: 10.1097/01.sla.0000072371.95588.da

To determine if transfusion affected perioperative and long-term outcome in patients undergoing liver resection for metastatic colorectal cancer. Blood transfusion produces host immunosuppression and has been postulated to result in adverse outcome for patients undergoing surgical resection of malignancies. Blood transfusion records and clinical outcomes for 1,351 patients undergoing liver resection at a tertiary cancer referral center were analyzed. Blood transfusion was associated with adverse outcome after liver resection. The greatest effect was in the perioperative course, where transfusion was an independent predictor of operative mortality, complications, major complications, and length of hospital stay. This effect was dose-related. Patients receiving one or two units or more than two units had an operative mortality of 2.5% and 11.1%, respectively, compared to 1.2% for patients not requiring transfusions. Transfusion was also associated with adverse long-term survival by univariate analysis, but this factor was not significant on multivariate analysis. Even patients receiving only one or two units had a more adverse outcome. 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.