Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico.
Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey, Mexico.
Clin Transplant. 2024 Jan;38(1):e15222. doi: 10.1111/ctr.15222. Epub 2023 Dec 8.
Hepatocellular carcinoma (HCC) is a significant cause of oncologic mortality worldwide. Liver transplantation represents a curative option for patients with significant liver dysfunction and absence of metastases. However, this therapeutic option is associated with significant blood loss and frequently requires various transfusions and intraoperative blood salvage for autotransfusion (IBS-AT) with or without a leukocyte reduction filter. This study aimed to analyze available evidence on long-term oncologic outcomes of patients undergoing liver transplantation for HCC with and without IBS-AT.
Per PRISMA guidelines, a systematic review of keywords "Blood Salvage," "Auto-transfusion," "Hepatocellular carcinoma," and "Liver-transplant" was conducted in PubMed, EMBASE, and SCOPUS. Studies comparing operative and postoperative outcomes were screened and analyzed for review.
Twelve studies totaling 1704 participants were included for analysis. Length of stay, recurrence rates, and overall survival were not different between IBS-AT group and non IBS-AT group.
IBS-AT use is not associated with increased risk of recurrence in liver transplant for HCC even without leukocyte filtration. Both operative and postoperative outcomes are similar between groups. Comparison of analyzed studies suggest that IBS-AT is safe for use during liver transplant for HCC.
肝细胞癌（HCC）是全球肿瘤死亡的重要原因。肝移植是肝功能严重受损且无转移的患者的一种治疗选择。然而，这种治疗方法会导致大量失血，通常需要进行各种输血和术中血液回收自体输血（IBS-AT），无论是否使用白细胞滤器。本研究旨在分析肝移植治疗 HCC 患者时使用和不使用 IBS-AT 的长期肿瘤学结果的现有证据。
根据 PRISMA 指南，在 PubMed、EMBASE 和 SCOPUS 中对关键词“血液回收”、“自体输血”、“肝细胞癌”和“肝移植”进行了系统综述。筛选并分析了比较手术和术后结果的研究进行综述。
共纳入 12 项研究，总计 1704 名参与者。IBS-AT 组和非 IBS-AT 组的住院时间、复发率和总生存率无差异。
即使没有白细胞过滤，IBS-AT 的使用与 HCC 肝移植后的复发风险增加无关。两组的手术和术后结果相似。对分析研究的比较表明，IBS-AT 在 HCC 肝移植期间使用是安全的。
