Advertisement

Surgery Today

, Volume 35, Issue 12, pp 1042–1046 | Cite as

Long-Term Safety of Autotransfusion During Hepatectomy for Hepatocellular Carcinoma

  • Tadamichi Hirano
  • Junichi Yamanaka
  • Yuji Iimuro
  • Jiro Fujimoto
Article

Abstract

Purpose

To evaluate the long-term safety of autotransfusion (AT) in hepatectomy for hepatocellular carcinoma (HCC).

Methods

Between 1988 and 1989, 46 patients with HCC underwent hepatectomy with AT (group 1). For a comparison, we matched 50 patients with HCC who underwent hepatectomy, and received homologous but not autologous blood (group 2). The 10-year cumulative survival curves and cancer-free curves of the two groups were examined, and the pattern of recurrence was compared.

Results

Group 1 had a significantly higher cumulative 10-year survival rate than group 2, at 20% vs 8%, respectively (P < 0.05). Among the patients who underwent curative resection, those in group 1 had significantly better cumulative survival and cancer-free survival rates than those in group 2, at 27% vs 11% (P < 0.05) and 13% vs 0% (P < 0.05), respectively. Among the patients with stage I–II HCC, those in group 1 had significantly better cumulative survival and cancer-free survival rates than those in group 2, at 30% vs 5% (P < 0.01) and 20% vs 5% (P < 0.05), respectively. However, the rates were similar among patients with stage III–IV disease in both groups. The pattern of recurrence in the two groups was similar.

Conclusion

Autotransfusion promoted survival in patients undergoing hepatectomy for stage I or II HCC.

Key words

Autotransfusion Hepatocellular car-cinoma Hepatectomy 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Fujimoto, J, Okamoto, E, Yamanaka, N, Oriyama, T, Furukawa, K, Kawamura, E,  et al. 1993Efficacy of autotransfusion in hepatectomy for hepatocellular carcinomaArch Surg12810659PubMedGoogle Scholar
  2. 2.
    Fujimoto, J, Okamoto, E, Yamanaka, N, Tanaka, T, Tanaka, W 1997Adverse effect of preoperative blood transfusions on survival after hepatic resection for hepatocellular carcinomaHepato-Gastroenterology4413906PubMedGoogle Scholar
  3. 3.
    Kitagawa, K, Taniguchi, H, Mugitani, T, Koh, T, Obayashi, T, Kunishima, S,  et al. 2001Safety and advantage of perioperative autologous blood transfusion in hepatic resection for hepatocellular carcinomaAnticancer Res2136637PubMedGoogle Scholar
  4. 4.
    Makino, Y, Yamanoi, A, Kimoto, T, El-Assal, ON, Kohno, H, Nagasue, N 2000The influence of perioperative blood transfusion on intrahepatic recurrence after curative resection of hepatocellular carcinomaAm J Gastroenterol951294300CrossRefPubMedGoogle Scholar
  5. 5.
    Gozzetti, G, Mazziotti, A, Grazi, GL, Jovine, E, Gallucci, A, Gruttadauria, S,  et al. 1995Liver resection without blood transfusionBr J Surg82110510PubMedGoogle Scholar
  6. 6.
    Asahara, T, Katayama, K, Itamoto, T, Yano, M, Hino, H, Okamoto, Y,  et al. 1999Perioperative blood transfusion as a prognostic indicator in patients with hepatocellular carcinomaWorld J Surg2367680PubMedGoogle Scholar
  7. 7.
    Opelz, G, Terasaki, PI 1978Improvement of kidney-graft survival with increased numbers of blood transfusionsN Engl J Med299799803PubMedGoogle Scholar
  8. 8.
    Opelz, G, Graver, B, Terasaki, PI 1981Induction of high kidney graft survival rate by multiple transfusionLancet112235PubMedGoogle Scholar
  9. 9.
    Foster, RS,Jr, Costanza, MC, Foster, JC, Wanner, MC, Foster, CB 1985Adverse relationship between blood transfusions and survival after colectomy for colon cancerCancer551195201PubMedGoogle Scholar
  10. 10.
    Kaneda, M, Horimi, T, Ninomiya, M, Nagae, S, Mukai, K, Takeda, I,  et al. 1987Adverse affect of blood transfusions on survival of patients with gastric cancerTransfusion273757CrossRefPubMedGoogle Scholar
  11. 11.
    Crowe, JP, Gordon, NH, Fry, DE, Shuck, JM, Hubay, CA 1989Breast cancer survival and perioperative blood transfusionSurgery10683641PubMedGoogle Scholar
  12. 12.
    Little, AG, Wu, HS, Ferguson, MK, Ho, CH, Bowers, VD, Segalin, A,  et al. 1990Perioperative blood transfusion adversely affects prognosis of patients with stage I non-small-cell lung cancerAm J Surg1606302PubMedGoogle Scholar
  13. 13.
    Tartter, PI 1992The association of perioperative blood transfusion with colorectal cancer recurrenceAnn Surg2166338PubMedGoogle Scholar
  14. 14.
    Motoyama, S, Saito, R, Kamata, S, Kitamura, M, Okuyama, M, Imano, H,  et al. 2002Survival advantage of using autologous blood transfusion during surgery for esophageal cancerSurg Today329518CrossRefPubMedGoogle Scholar
  15. 15.
    Kaplan, J, Sarnaik, S, Gitlin, J, Lusher, J 1984Diminished helper/suppressor lymphocyte ratios and natural killer activity in recipients of repeated blood transfusionsBlood6430810PubMedGoogle Scholar
  16. 16.
    Kwon, AH, Matsui, Y, Kamiyama, Y 2001Perioperative blood transfusion in hepatocellular carcinomas: influence of immunologic profile and recurrence free survivalCancer917718CrossRefPubMedGoogle Scholar
  17. 17.
    Tartter, PI, Steinberg, B, Barron, DM, Martinelli, G 1987The prognostic significance of natural killer cytotoxicity in patients with colorectal cancerArch Surg12212648PubMedGoogle Scholar
  18. 18.
    Hanna, N, Fidler, IJ 1980Role of natural killer cells in the destruction of circulating tumor emboliJ Natl Cancer Inst658019PubMedGoogle Scholar
  19. 19.
    Okabayashi, T, Tanaka, N, Satomi, S, Suzuki, H, Takagi, H, Takahashi, T,  et al. 1999Efficacy of autologous blood transfusion using recombinant human erythropoietin and postoperative cell mediated immunity in patients with gastrointestinal cancer (in Japanese with English abstract)Jpn J Gastroenterol Surg32233949Google Scholar
  20. 20.
    Yaw, PB, Sentany, M, Link, WJ, Wahle, WM, Glover, JL 1975Tumor cells carried through autotransfusion. Contraindication to intraoperative blood recovery?JAMA2314901CrossRefPubMedGoogle Scholar
  21. 21.
    Salsbury, AJ 1975The significance of the circulating cancer cellCancer Treat Rev25572PubMedGoogle Scholar
  22. 22.
    Griffiths, JD, McKinna, JA, Rowbotham, HD, Tsolakidis, P, Salsbury, AJ 1973Carcinoma of the colon and rectum: circulating malignant cells and five-year survivalCancer3122636PubMedGoogle Scholar
  23. 23.
    Yoshida, M, Kawano, K, Shinnasyu, H 1994Malignant cell activity in preserved autologous blood (in Japanese)Jikoketsuyuketsu7146Google Scholar
  24. 24.
    Kitagawa, K, Taniguchi, H, Mugitani, T, Koh, T, Obayashi, T, Kunishima, S,  et al. 2001Safety and advantage of perioperative autologous blood transfusion in hepatic resection for hepatocellular carcinomaAnticancer Res2136637PubMedGoogle Scholar
  25. 25.
    Shinozuka, N, Koyama, I, Arai, T, Numajiri, Y, Watanabe, T, Nagashima, N,  et al. 2000Autologous blood transfusion in patients with hepatocellular carcinoma undergoing hepatectomyAm J Surg179425CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 2005

Authors and Affiliations

  • Tadamichi Hirano
    • 1
  • Junichi Yamanaka
    • 1
  • Yuji Iimuro
    • 1
  • Jiro Fujimoto
    • 1
  1. 1.First Department of SurgeryHyogo College of MedicineNishinomiyaJapan

Personalised recommendations