Editorial
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Aug 28, 2009; 15(32): 3976-3983
Published online Aug 28, 2009. doi: 10.3748/wjg.15.3976
Effect of perioperative blood transfusion on clinical outcomes in hepatic surgery for cancer
Gianlorenzo Dionigi, Luigi Boni, Francesca Rovera, Stefano Rausei, Salvatore Cuffari, Giovanni Cantone, Alessandro Bacuzzi, Renzo Dionigi
Gianlorenzo Dionigi, Luigi Boni, Francesca Rovera, Stefano Rausei, Renzo Dionigi, Department of Surgical Sciences, Azienda Ospedaliera-Polo Universitario, University of Insubria, Via Guicciardini, 21100 Varese, Italy
Salvatore Cuffari, Giovanni Cantone, Alessandro Bacuzzi, Department of Anesthesiology, Azienda Ospedaliera-Polo Universitario, 21100 Varese, Italy
Author contributions: Dionigi G contributed to acquisition of data; Boni L and Rovera F contributed equally to study conception and design; Rausei S analyzed and interpreted the data; Cuffari S, Cantone G and Bacuzzi A performed the drafting of manuscript; Dionigi R contributed to critical revision and supervision.
Correspondence to: Gianlorenzo Dionigi, MD, Associate Professor of Surgery, Department of Surgical Sciences, Azienda Ospedaliera-Polo Universitario, University of Insubria, Via Guicciardini, 21100 Varese, Italy. gianlorenzo.dionigi@uninsubria.it
Telephone: +39-332-278450
Fax: +39-332-260260
Received: June 4, 2009
Revised: July 20, 2009
Accepted: July 27, 2009
Published online: August 28, 2009
Abstract

Allogeneic blood transfusion during liver resection for malignancies has been associated with an increased incidence of different types of complications: infectious complications, tumor recurrence, decreased survival. Even if there is clear evidence of transfusion-induced immunosuppression, it is difficult to demonstrate that transfusion is the only determinant factor that decisively affects the outcome. In any case there are several motivations to reduce the practice of blood transfusion. The advantages and drawbacks of different transfusion alternatives are reviewed here, emphasizing that surgeons and anesthetists who practice in centers with a high volume of liver resections, should be familiar with all the possible alternatives.

Keywords: Blood transfusion, Blood products, Allogeneic blood transfusion, Intraoperative autotransfusion, Preoperative autologous blood donation, Intraoperative isovolemic hemodilution, Infectious complications, Liver resection, Hepatocellular carcinoma