Shinozuka N, Koyama I, Arai T, Numajiri Y, Watanabe T, Nagashima N, Matsumoto T, Ohata M, Anzai H, Omoto R
First Department of Surgery, Saitama Medical School, Japan.
Am J Surg. 2000 Jan;179(1):42-5. doi: 10.1016/s0002-9610(99)00256-1.
Homologous blood transfusion (HBT) has the risk of an immunosuppressive effect and may adversely affect the prognosis of patients with carcinomas. Autologous blood transfusion (ABT) has not yet become a standard procedure in gastroenteric cancer surgery. We investigated the usefulness and problems of ABT combined with the use of recombinant human erythropoietin (rh-EPO).
An evaluation of autologous blood transfusion (ABT) combined with recombinant human erythropoietin (rh-EPO) treatment was conducted in 46 patients with hepatocellular carcinoma undergoing hepatectomy. Preoperative autologous blood donation (ABD) was accomplished for 25 of the 46 patients. The preoperative changes in hemoglobin and hematocrit in relation to route of administration of erythropoietin were studied. In addition, intraoperative blood requirements and the postoperative complications for patients who predonated were compared with those of patients who underwent surgery without autologous predonation.
The proportion of patients not requiring additional homologous blood transfusions (HBT) during operation was significantly higher in the ABD group than in the non-ABD group (88% versus 38%). The incidence of postoperative complications was significantly higher in patients receiving HBT than in nontransfused patients and in those receiving ABT.
Preoperative autologous blood donation in combination with rh-EPO therapy markedly reduced the requirement for homologous blood transfusion during surgery in patients with hepatocellular carcinoma having hepatectomy.
同种异体输血（HBT）存在免疫抑制作用的风险，可能对癌症患者的预后产生不利影响。自体输血（ABT）尚未成为胃肠癌手术的标准操作。我们研究了ABT联合使用重组人促红细胞生成素（rh-EPO）的有效性和问题。
对46例接受肝切除术的肝细胞癌患者进行了自体输血（ABT）联合重组人促红细胞生成素（rh-EPO）治疗的评估。46例患者中有25例进行了术前自体血捐献（ABD）。研究了促红细胞生成素给药途径与术前血红蛋白和血细胞比容的变化。此外，将预先献血患者的术中用血需求和术后并发症与未进行自体预献血的手术患者进行了比较。
ABD组术中不需要额外进行同种异体输血（HBT）的患者比例显著高于非ABD组（88%对38%）。接受HBT的患者术后并发症发生率显著高于未输血患者和接受ABT的患者。
术前自体血捐献联合rh-EPO治疗显著降低了接受肝切除术的肝细胞癌患者手术期间同种异体输血的需求。
