Brief Article
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World J Gastroenterol. Aug 28, 2011; 17(32): 3709-3715
Published online Aug 28, 2011. doi: 10.3748/wjg.v17.i32.3709
Advantage of autologous blood transfusion in surgery for hepatocellular carcinoma
Yoshito Tomimaru, Hidetoshi Eguchi, Shigeru Marubashi, Hiroshi Wada, Shogo Kobayashi, Masahiro Tanemura, Koji Umeshita, Yuichiro Doki, Masaki Mori, Hiroaki Nagano
Yoshito Tomimaru, Hidetoshi Eguchi, Shigeru Marubashi, Hiroshi Wada, Shogo Kobayashi, Masahiro Tanemura, Koji Umeshita, Yuichiro Doki, Masaki Mori, Hiroaki Nagano, Department of Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita 565-0871, Osaka, Japan
Koji Umeshita, Division of Health Sciences, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita 565-0871, Osaka, Japan
Author contributions: Tomimaru Y was responsible for the review of the literature and initial preparation of the paper; Eguchi H, Marubashi S, Wada H, Kobayashi S, Tanemura M, and Umeshita K supported the preparation; Doki Y, Mori M, and Nagano H prepared the final version of the manuscript.
Correspondence to: Hiroaki Nagano, MD, PhD, Department of Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka E-2, Suita 565-0871, Osaka, Japan. hnagano@gesurg.med.osaka-u.ac.jp
Telephone: +81-6-6879-3251 Fax: +81-6-6879-3259
Received: October 12, 2010
Revised: November 17, 2010
Accepted: November 24, 2010
Published online: August 28, 2011
Abstract

AIM: To evaluate the significance of autologous blood transfusion (AT) in reducing homologous blood transfusion (HT) in surgery for hepatocellular carcinoma (HCC).

METHODS: The proportion of patients who received HT was compared between two groups determined by the time of AT introduction; period A (1991-1994, n = 93) and period B (1995-2000, n = 201). Multivariate logistic regression analysis was performed in order to identify independent significant predictors of the need for HT. We also investigated the impact of AT and HT on long-term postoperative outcome after curative surgery for HCC.

RESULTS: The proportion of patients with HT was significantly lower in period B than period A (18.9% vs 60.2%, P < 0.0001). Multivariate logistic regression analysis identified AT administration as a significant independent predictor of the need for HT (P < 0.0001). Disease-free survival in patients with AT was comparable to that without any transfusion. Multivariate analysis identified HT administration as an independent significant factor for poorer disease-free survival (P = 0.0380).

CONCLUSION: AT administration significantly decreased the need for HT. Considering the postoperative survival disadvantage of HT, AT administration could improve the long-term outcome of HCC patients.

Keywords: Hepatocellular carcinoma; Surgery; Auto-logous blood transfusion; Homologous blood transfusion