Transfusions following hepatic resection for colorectal metastases

Perioperative blood transfusion is a risk factor for poor outcome after liver resection, finds a research team in the June issue of Annals of Surgery.

In this study, researchers from New York, USA, assessed whether transfusion affected perioperative and long-term outcome in patients undergoing liver resection for metastatic colorectal cancer.

Blood transfusion produces host immunosuppression. It is thought that it may result in adverse outcome for patients undergoing surgical resection of malignancies.

Blood transfusion was associated with adverse outcome.

Annals of Surgery

The team analyzed blood transfusion records and clinical outcomes for 1351 patients undergoing liver resection at a tertiary cancer referral center.

The researchers determined that blood transfusion was associated with adverse outcome after liver resection. They found that perioperative transfusion had the greatest effect.

Transfusion was an independent predictor of operative mortality, complications, major complications, and length of hospital stay.

The team found that this effect was dose-related. Patients who received either 1 or 2 units, or more than 2 units had an operative mortality of 3% and 11%, respectively. Operative mortality was 1% for patients not requiring transfusions.

Univariate analysis determined that transfusion was associated with adverse long-term survival. Patients who received only 1 or 2 units had an adverse outcome. However, this was not significant on multivariate analysis.

Dr David Kooby's team concluded, "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".