Ishizawa Takeaki, Hasegawa Kiyoshi, Tsuno Nelson Hirokazu, Tanaka Minoru, Mise Yoshihiro, Aoki Taku, Imamura Hiroshi, Beck Yoshifumi, Sugawara Yasuhiko, Makuuchi Masatoshi, Takahashi Koki, Kokudo Norihiro
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
J Am Coll Surg. 2009 Aug;209(2):206-14. doi: 10.1016/j.jamcollsurg.2009.03.004. Epub 2009 May 1.
The aim of this study was to evaluate the safety of predeposit autologous plasma donation (PAPD) and its efficacy in avoiding allogenic blood transfusions and albumin infusion in liver resection for hepatocellular carcinoma.
PAPD was adopted in 20 patients in whom liver function remained within Child-Pugh's class A and an indocyanine green retention rate at 15 minutes was < or = 15% (PAPD group). Up to 1,200 mL of autologous fresh frozen plasma was collected through three blood donation sessions. Allogenic blood transfusion rates, albumin infusion rates, and postoperative courses were compared between the PAPD group and a historic control (no PAPD) group (n = 36).
Serum albumin levels after the last blood donation session were not significantly different from those before PAPD. The prothrombin activity even increased through the blood donation sessions (from median 80.9% [range 70.0% to 100%] to median 89.2% [range 71.2% to 100%]; p < 0.001). Allogenic blood transfusion rate and albumin infusion rate were lower in the PAPD group than in the no PAPD group (11% versus 75%; p < 0.001 and 16% versus 47%; p = 0.038, respectively). Wastage rate of the autologous fresh frozen plasma products was 9%.
PAPD was safe in patients with underlying liver disease and can be beneficial in simulating the liver synthetic function in advance of operation. Autologous fresh frozen plasma transfusion was effective for avoiding allogenic blood products in liver resection for hepatocellular carcinoma.
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