ADVERSE EFFECT OF PERIOPERATIVE BLOOD-TRANSFUSIONS ON SURVIVAL AFTER HEPATIC RESECTION FOR HEPATOCELLULAR-CARCINOMA

Background/Aims: Experimental and clinical studies have found a relati onship between blood transfusion and altered immune function. We estim ated the risk of transfusions for shorter survival on. patients with h epatocellular carcinoma who underwent hepatic resection. Methodology: The impact of perioperative blood transfusions on 235 patients with he patocellular carcinoma who had resections from January 1981 to Decembe r 1988 was retrospectively examined. All patients underwent hepatic re section and received no additional chemotherapy. Results: Using the Co x proportional hazard model, the number of perioperative blood transfu sions was found to be a significant prognostic factor for patient outc ome (p=0.03). Overall, patients who received less than. 12 transfused units had a significantly better 5-year survival rate than those who r eceived more than 13 transfused units (46.3% vs. 24.5%, p<0.001). This result was also seen when, the patients were subdivided by stage: 5-y ear survival in the early stage group (57.2% vs. 35.5%, p<0.01) and in the advanced stage group (30.0% vs. 18.2%, p<0.05). The number of per ioperative blood transfusions also influenced the survival of patients who underwent a curative resection (66.2% vs. 38.5%, p<0.01), but did not affect the survival of those who received a non-curative resectio n (7.9% vs. 7.4%). Conclusion: This study suggests that the number of perioperative blood transfusions is a significant prognostic factor in patients with hepatocellular carcinoma who undergo hepatic resection.