Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
J Surg Oncol. 2013 Dec;108(7):486-91. doi: 10.1002/jso.23426. Epub 2013 Sep 5.
It remains unclear what kinds of patients undergoing hepatectomy for hepatocellular carcinoma (HCC) actually need autologous blood storage/transfusion.
Prior to surgery, autologous blood storage was prospectively performed in 245 patients with HCC, whereas it was not performed in 40 patients. Based on the use of the deposited autologous blood and the estimated postoperative hemoglobin (Hb) level when blood was not deposited, they were divided into necessary group and unnecessary group. By comparing the two groups, a scoring system to predict the need for autologous blood was established.
The 245 patients from whom blood was collected and stored were categorized into necessary group (32 patients with homologous blood transfusion and 11 with estimated postoperative Hb of <8.0 g/dl) and unnecessary group (30 patients with autologous blood discarded and 172 with estimated Hb ≥ 8.0 g/dl). Using factors that were significantly different between the two groups, a scoring system to predict the need for autologous blood was developed; preoperative Hb level, tumor size, and tumor thrombus. The area under the receiver-operator characteristic curve of the score was 0.836.
The established scoring system was found useful in identifying those HCC patients who need autologous blood storage/transfusion during hepatectomy.
接受肝癌（HCC）肝切除术的患者中，究竟哪些患者确实需要自体血储存/输血，目前仍不清楚。
在手术前，前瞻性地对 245 例 HCC 患者进行了自体血储存，而对 40 例患者未进行自体血储存。根据储存的自体血的使用情况和未储存时估计的术后血红蛋白（Hb）水平，将患者分为必要组和不必要组。通过比较两组，建立了预测自体血需求的评分系统。
从采集和储存血液的 245 例患者中，分为必要组（32 例接受同种异体输血，11 例估计术后 Hb<8.0 g/dl）和不必要组（30 例自体血废弃，172 例估计 Hb≥8.0 g/dl）。使用两组之间有显著差异的因素，建立了预测自体血需求的评分系统；术前 Hb 水平、肿瘤大小和肿瘤血栓。评分的受试者工作特征曲线下面积为 0.836。
该评分系统有助于识别接受肝癌切除术的 HCC 患者中需要自体血储存/输血的患者。
