Skip to main content

Advertisement

SpringerLink
Log in

Necessity for autologous blood storage and transfusion in patients undergoing pancreatoduodenectomy

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

To establish which patients undergoing pancreaticoduodenectomy (PD) need autologous blood storage and transfusion.

Methods

Autologous blood was collected and stored for 69 patients scheduled to undergo PD, and not used in 50 patients. Based on the use of the deposited autologous blood and the estimated postoperative hemoglobin (Hb) level when blood was not deposited, we divided the patients into a “transfusion necessary” group and a “transfusion unnecessary” group. By comparing the two groups, we proposed a method of scoring to predict the necessity for storing autologous blood.

Results

The “transfusion necessary” group comprised 6 patients (2 who received homologous blood transfusion and 4 with an estimated postoperative Hb of <8.0 g/dL) and the “transfusion unnecessary” group comprised 63 patients (24 whose autologous blood was discarded and 39 with an estimated Hb ≥8.0 g/dL). By analyzing the differences between the groups, including the preoperative hemoglobin level and the need for portal vein resection, we devised a scoring system to predict the necessity of collecting autologous blood. The scoring significantly correlated with the proportion of patients who did not require autologous blood storage and transfusion.

Conclusions

Not all patients benefited from autologous blood storage and transfusion. Our scoring system proved useful for identifying which patients required autologous blood storage and transfusion during PD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Blumberg N, Heal JM. Effects of transfusion on immune function. Cancer recurrence and infection. Arch Pathol Lab Med. 1994;118:371–9.

    CAS  PubMed  Google Scholar 

  2. Goodnough LT, Brecher ME, Kanter MH, AuBuchon JP. Transfusion medicine. First of two parts—blood transfusion. N Engl J Med. 1999;340:438–47.

    Article  CAS  PubMed  Google Scholar 

  3. Katayama H, Kurokawa Y, Nakamura K, Ito H, Kanemitsu Y, Masuda N, et al. Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg Today. 2016;46:668–85.

    Article  PubMed  Google Scholar 

  4. Sutton JM, Kooby DA, Wilson GC, Squires MH 3rd, Hanseman DJ, Maithel SK, et al. Perioperative blood transfusion is associated with decreased survival in patients undergoing pancreaticoduodenectomy for pancreatic adenocarcinoma: a multi-institutional study. J Gastrointest Surg. 2014;18:1575–87.

    Article  PubMed  Google Scholar 

  5. Busch OR, Hop WC, Hoynck van Papendrecht MA, Marquet RL, Jeekel J. Blood transfusions and prognosis in colorectal cancer. N Engl J Med. 1993;328:1372–6.

    Article  CAS  PubMed  Google Scholar 

  6. Bortul M, Calligaris L, Roseano M, Leggeri A. Blood transfusions and results after curative resection for gastric cancer. Suppl Tumori. 2003;2:S27–30.

    PubMed  Google Scholar 

  7. Komatsu Y, Orita H, Sakurada M, Maekawa H, Hoppo T, Sato K. Intraoperative blood transfusion contributes to decreased long-term survival of patients with esophageal cancer. World J Surg. 2012;36:844–50.

    Article  PubMed  Google Scholar 

  8. Tomimaru Y, Eguchi H, Marubashi S, Wada H, Kobayashi S, Tanemura M, et al. Advantage of autologous blood transfusion in surgery for hepatocellular carcinoma. World J Gastroenterol. 2011;17:3709–15.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Arima K, Hashimoto D, Okabe H, Inoue R, Kaida T, Higashi T, et al. Intraoperative blood loss is not a predictor of prognosis for pancreatic cancer. Surg Today. 2016;46:792–7.

    Article  CAS  PubMed  Google Scholar 

  10. Mizuguchi T, Torigoe T, Satomi F, Shima H, Kutomi G, Ota S, et al. Trials of vaccines for pancreatic ductal adenocarcinoma: is there any hope of an improved prognosis? Surg Today. 2016;46:139–48.

    Article  CAS  PubMed  Google Scholar 

  11. Goodnough LT. Autologous blood donation. Crit Care. 2004;8(Suppl 2):S49–52.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Thomas MJ, Gillon J, Desmond MJ. Consensus conference on autologous transfusion. Preoperative autologous donation. Transfusion. 1996;36:633–9.

    Article  CAS  PubMed  Google Scholar 

  13. Cohen JA, Brecher ME. Preoperative autologous blood donation: benefit or detriment? A mathematical analysis. Transfusion. 1995;35:640–4.

    Article  CAS  PubMed  Google Scholar 

  14. Kasper SM, Ellering J, Stachwitz P, Lynch J, Grunenberg R, Buzello W. All adverse events in autologous blood donors with cardiac disease are not necessarily caused by blood donation. Transfusion. 1998;38:669–73.

    Article  CAS  PubMed  Google Scholar 

  15. Goodnough LT, Brecher ME, Kanter MH, AuBuchon JP. Transfusion medicine. Second of two parts—blood conservation. N Engl J Med. 1999;340:525–33.

    Article  CAS  PubMed  Google Scholar 

  16. Tomimaru Y, Eguchi H, Wada H, Hama N, Kawamoto K, Kobayashi S, et al. Predicting the necessity of autologous blood collection and storage before surgery for hepatocellular carcinoma. J Surg Oncol. 2013;108:486–91.

    Article  CAS  PubMed  Google Scholar 

  17. Couvret C, Tricoche S, Baud A, Dabo B, Buchet S, Palud M, et al. The reduction of preoperative autologous blood donation for primary total hip or knee arthroplasty: the effect on subsequent transfusion rates. Anesth Analg. 2002;94:815–23 (table of contents).

    Article  PubMed  Google Scholar 

  18. Basran S, Frumento RJ, Cohen A, Lee S, Du Y, Nishanian E, et al. The association between duration of storage of transfused red blood cells and morbidity and mortality after reoperative cardiac surgery. Anesth Analg. 2006;103:15–20 (table of contents).

    Article  PubMed  Google Scholar 

  19. Koch CG, Li L, Sessler DI, Figueroa P, Hoeltge GA, Mihaljevic T, et al. Duration of red-cell storage and complications after cardiac surgery. N Engl J Med. 2008;358:1229–39.

    Article  CAS  PubMed  Google Scholar 

  20. Popovsky MA, Whitaker B, Arnold NL. Severe outcomes of allogeneic and autologous blood donation: frequency and characterization. Transfusion. 1995;35:734–7.

    Article  CAS  PubMed  Google Scholar 

  21. Etchason J, Petz L, Keeler E, Calhoun L, Kleinman S, Snider C, et al. The cost effectiveness of preoperative autologous blood donations. N Engl J Med. 1995;332:719–24.

    Article  CAS  PubMed  Google Scholar 

  22. Kruskall MS. Cost effectiveness of autologous blood donation. N Engl J Med. 1995;333:461–2 (author reply 3).

    Article  CAS  PubMed  Google Scholar 

  23. Brecher ME, Goodnough LT. The rise and fall of preoperative autologous blood donation. Transfusion. 2001;41:1459–62.

    Article  CAS  PubMed  Google Scholar 

  24. Vanderlinde ES, Heal JM, Blumberg N. Autologous transfusion. BMJ. 2002;324:772–5.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Carless P, Moxey A, O’Connell D, Henry D. Autologous transfusion techniques: a systematic review of their efficacy. Transfus Med. 2004;14:123–44.

    Article  CAS  PubMed  Google Scholar 

  26. Heiss MM, Fasol-Merten K, Allgayer H, Strohlein MA, Tarabichi A, Wallner S, et al. Influence of autologous blood transfusion on natural killer and lymphokine-activated killer cell activities in cancer surgery. Vox Sang. 1997;73:237–45.

    Article  CAS  PubMed  Google Scholar 

  27. Sagawa K, Omokawa S, Furukawa Y. New guideline for autologous blood transfusion (in Japanese). J Jpn Soc Autologous Blood Transfus. 2007;20:10–34.

    Google Scholar 

  28. Japanese Ministry of Health LaW. Blood transfusion guideline (in Japanese). 3rd ed. Tokyo: Jiho Co; 2005.

    Google Scholar 

  29. Itamoto T, Katayama K, Nakahara H, Tashiro H, Asahara T. Autologous blood storage before hepatectomy for hepatocellular carcinoma with underlying liver disease. Br J Surg. 2003;90:23–8.

    Article  CAS  PubMed  Google Scholar 

  30. Pulitano C, Arru M, Bellio L, Rossini S, Ferla G, Aldrighetti L. A risk score for predicting perioperative blood transfusion in liver surgery. Br J Surg. 2007;94:860–5.

    Article  CAS  PubMed  Google Scholar 

  31. Lennox PA, Clugston PA, Beasley ME, Bostwick J 3rd. Autologous blood transfusion in TRAM breast reconstruction: is it necessary? Ann Plast Surg. 2004;53:532–5.

    Article  PubMed  Google Scholar 

  32. Vega SJ, Nguyen TV, Forsberg C, Hua LB, Kirkley SA, Herrera HR, et al. Efficacy of preoperative autologous blood donation in free TRAM flap breast reconstruction. Plast Reconstr Surg. 2008;121:241e–6e.

    Article  PubMed  Google Scholar 

  33. Billote DB, Abdoue AG, Wixson RL. Comparison of acute normovolemic hemodilution and preoperative autologous blood donation in clinical practice. J Clin Anesth. 2000;12:31–5.

    Article  CAS  PubMed  Google Scholar 

  34. Weber RS, Jabbour N, Martin RC 2nd. Anemia and transfusions in patients undergoing surgery for cancer. Ann Surg Oncol. 2008;15:34–45.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara, Toyonaka, Osaka, 560-8565, Japan

    Yoshito Tomimaru, Kozo Noguchi & Keizo Dono

Authors
  1. Yoshito Tomimaru
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kozo Noguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Keizo Dono
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yoshito Tomimaru.

Ethics declarations

Conflict of interest

Yoshito Tomimaru and his co-authors have no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tomimaru, Y., Noguchi, K. & Dono, K. Necessity for autologous blood storage and transfusion in patients undergoing pancreatoduodenectomy. Surg Today 47, 568–574 (2017). https://doi.org/10.1007/s00595-016-1407-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-016-1407-4

Keywords

Search

Navigation