Safety and utility of autologous blood transfusion for resection of metastatic liver tumor
Obayashi, T.; Taniguchi, H.; Mugitani, T.; Koh, T.; Kitagawa, K.; Kunishima, S.; Yamaguchi, A.; Yamagishi, H.
Hepato-Gastroenterology 48(39): 812-817
2001
ISSN/ISBN: 0172-6390 PMID: 11462930 Document Number: 1907
Background/Aims: The purpose of this study was to evaluate the safety and efficacy of predeposit autologous blood transfusion for resection of hepatic metastases. Methodology: We examined stored blood from 25 patients with advanced colorectal or gastric cancer for carcinoembryonic antigen mRNA using reverse-transcriptase-polymerase chain reaction assay to detect cancer cell in the autologous blood. We also retrospectively evaluated no transfusion (A, n=44), autologous transfusion (B, n=15), and homologous transfusion groups (C, n=26) for perioperative liver function and long-term outcome after undergoing resection of liver metastases. Results: In 5 of 25 patients, carcinoembryonic antigen mRNA was detected immediately after blood donation and after 7 days of storage, but not after 14-21 days of storage. The cumulative 5-year survival rates for groups A, B, and C were not different. However, disease-free survival with colorectal liver metastases was significantly higher in group A than in group C (P=0.019). Total bilirubin concentrations in group C on the first postoperative day were also significantly higher than group A (P=0.025). Conclusions: Stored autologous blood may contain cancer cells, but these decrease or disappear after storage for more than 7 days. For hepatic resection of metastases, transfusion avoidance yields the optimal outcome.
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