Wada Hiroshi, Eguchi Hidetoshi, Nagano Hiroaki, Kubo Shoji, Nakai Takuya, Kaibori Masaki, Hayashi Michihiro, Takemura Shigekazu, Tanaka Shogo, Nakata Yasuyuki, Matsui Kosuke, Ishizaki Morihiko, Hirokawa Fumitoshi, Komeda Koji, Uchiyama Kazuhisa, Kon Masanori, Doki Yuichiro, Mori Masaki
Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, 565-0871, Japan.
Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Osaka, 545-8585, Japan.
Surg Today. 2018 Jan;48(1):73-79. doi: 10.1007/s00595-017-1553-3. Epub 2017 Jun 8.
The influence of allogenic blood transfusion on the postoperative outcomes of hepatocellular carcinoma (HCC) surgery remains controversial. This study aims to clarify the clinical impacts of perioperative allogenic blood transfusion on liver resection outcome in HCC patients.
We analyzed data collected over 5 years for 642 patients who underwent hepatectomy for HCC at one of the five university hospitals. We investigated the impact of allogenic blood transfusion on postoperative outcome after surgery in all patients and in 74 matched pairs, using a propensity score.
Of the 642 patients, 198 (30.8%) received perioperative allogenic blood transfusion (AT group) and 444 (69.2%) did not (non-AT group). Overall survival was lower in the AT group than in the non-AT group in univariate (P < 0.001) and multivariate analyses (risk ratio 1.521, P = 0.011). After matching the different distributions using propensity scores, perioperative blood transfusion was found to be a poor prognostic factor for HCC patients.
In this multi-center study, perioperative blood transfusion was an independent factor for poor prognosis after curative surgery for primary HCC in the patient group and in pairs matched by propensity scores.
异体输血对肝细胞癌（HCC）手术术后结局的影响仍存在争议。本研究旨在阐明围手术期异体输血对HCC患者肝切除结局的临床影响。
我们分析了在五所大学医院之一接受HCC肝切除术的642例患者5年期间收集的数据。我们使用倾向评分研究了异体输血对所有患者以及74对匹配患者术后结局的影响。
642例患者中，198例（30.8%）接受了围手术期异体输血（输血组），444例（69.2%）未接受（非输血组）。在单因素分析（P < 0.001）和多因素分析（风险比1.521，P = 0.011）中，输血组的总生存率低于非输血组。使用倾向评分匹配不同分布后，发现围手术期输血是HCC患者的不良预后因素。
在这项多中心研究中，围手术期输血是患者组以及倾向评分匹配对中，原发性HCC根治性手术后预后不良的独立因素。
