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Leucocyte-Depleted Blood Transfusion is an Independent Predictor of Surgical Morbidity in Patients Undergoing Elective Colon Cancer Surgery—A Single-Center Analysis of 531 Patients

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Leukocyte-depleted packed red blood cells (PRBC) were introduced to reduce potential immunomodulatory effects and transfusion-associated morbidity. It has, however, remained unclear, if leucocyte depletion prevents negative side effects of blood transfusion. The aim of this analysis was to examine the effects of leukocyte-depleted PRBC on surgical morbidity after elective colon cancer surgery.

Methods

Data were prospectively collected from 531 consecutive patients undergoing elective colon cancer surgery at a single high-volume center (University Hospital) from 2002 to 2008. Potentially predictive factors for surgical morbidity were tested on univariate and multivariate analysis.

Results

A total of 531 patients with colon cancer were included. A curative (R0) resection was performed in 497 patients (94%). The mortality rate, overall morbidity rate, and surgical morbidity rate were 1.1, 33, and 21%, respectively. Some 135 patients (25%) received perioperative transfusion of PRBCs. On multivariate analysis age (odds ratio [OR] 1.04, 95% confidence interval [95% CI] 1.02–1.06; P = 0.001), BMI (OR 1.08, 95% CI 1.03–1.13; P = 0.003), and PRBC transfusion (2.4, 1.41–4.11; P = 0.001) were revealed as independent predictors of surgical morbidity. The risk of surgical complications increased continuously with the amount of transfused PRBCs. The adverse impact of PRBC transfusion was neither restricted to the timepoint of transfusion (intraoperative or postoperative), nor to the kind of complication (infectious vs noninfectious complication).

Conclusion

Perioperative transfusion of leukocyte-depleted PRBCs has a significantly negative effect on surgical morbidity of patients undergoing elective colon cancer surgery. The use of perioperative blood transfusions in these patients should be avoided, whenever possible.

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Acknowledgment

The authors thank Doris Hall for excellent assistance with data collection.

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Authors and Affiliations

  1. Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany

    M. Koch MD, D. Antolovic MD, C. Reissfelder, N. N. Rahbari MD, J. Holoch, I. Michalski, H. Sweiti, A. Ulrich MD, M. W. Büchler MD & J. Weitz MD, MSc

Authors
  1. M. Koch MD
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  2. D. Antolovic MD
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  3. C. Reissfelder
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  4. N. N. Rahbari MD
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  5. J. Holoch
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  6. I. Michalski
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  7. H. Sweiti
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  8. A. Ulrich MD
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  9. M. W. Büchler MD
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  10. J. Weitz MD, MSc
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Corresponding author

Correspondence to N. N. Rahbari MD.

Additional information

Authors M. Koch and D. Antolovic contributed equally to this study.

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Koch, M., Antolovic, D., Reissfelder, C. et al. Leucocyte-Depleted Blood Transfusion is an Independent Predictor of Surgical Morbidity in Patients Undergoing Elective Colon Cancer Surgery—A Single-Center Analysis of 531 Patients. Ann Surg Oncol 18, 1404–1411 (2011). https://doi.org/10.1245/s10434-010-1453-x

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  • DOI: https://doi.org/10.1245/s10434-010-1453-x

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