Influence of Transfusions on Perioperative and Long-Term Outcome in Patients Following Hepatic Resection for Colorectal Metastases

David A. Kooby, Jennifer Stockman, Leah Ben-Porat, Mithat Gonen, William R. Jarnagin, Ronald P. Dematteo, Scott Tuorto, David Wuest, Leslie H. Blumgart, Yuman Fong, John S. Bolton, Michael A. Choti, Bryan Clary, Clinton E. Baisden, Yuman Fong

Research output: Contribution to journalArticle

Abstract

Objective: To determine if transfusion affected perioperative and long-term outcome in patients undergoing liver resection for metastatic colorectal cancer. Summary Background Data: Blood transfusion produces host immunosuppression and has been postulated to result in adverse outcome for patients undergoing surgical resection of malignancies. Methods: Blood transfusion records and clinical outcomes for 1,351 patients undergoing liver resection at a tertiary cancer referral center were analyzed. Results: Blood transfusion was a-ssociated n-with adverse outcome after liver resection. The greatest effect was in the perioperative course, where transfusion was an independent predictor of operative mortality, complications, major complications, and length of hospital stay. This effect was dose-related. Patients receiving one or two units or more than two units had an operative mortality of 2.5% and 11.1%, respectively, compared to 1.2% for patients not requiring transfusions. Transfusion was also associated with adverse long-term survival by univariate analysis, but this factor was not significant on multivariate analysis. Even patients receiving only one or two units had a more adverse outcome. Conclusions: Perioperative blood transfusion is a risk factor for poor outcome after liver resection. Blood conservation methods should be used to avoid transfusion, especially in patents currently requiring limited amounts of transfused blood products.

Original languageEnglish (US)
Pages (from-to)860-870
Number of pages11
JournalAnnals of Surgery
Volume237
Issue number6
DOIs
StatePublished - Jun 2003
Externally publishedYes

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Neoplasm Metastasis
Blood Transfusion
Liver
Length of Stay
Patents
Mortality
Survival Analysis
Tertiary Care Centers
Immunosuppression
Colorectal Neoplasms
Neoplasms
Multivariate Analysis

ASJC Scopus subject areas

  • Surgery

Cite this

Kooby, D. A., Stockman, J., Ben-Porat, L., Gonen, M., Jarnagin, W. R., Dematteo, R. P., ... Fong, Y. (2003). Influence of Transfusions on Perioperative and Long-Term Outcome in Patients Following Hepatic Resection for Colorectal Metastases. Annals of Surgery, 237(6), 860-870. https://doi.org/10.1097/00000658-200306000-00015

Influence of Transfusions on Perioperative and Long-Term Outcome in Patients Following Hepatic Resection for Colorectal Metastases. / Kooby, David A.; Stockman, Jennifer; Ben-Porat, Leah; Gonen, Mithat; Jarnagin, William R.; Dematteo, Ronald P.; Tuorto, Scott; Wuest, David; Blumgart, Leslie H.; Fong, Yuman; Bolton, John S.; Choti, Michael A.; Clary, Bryan; Baisden, Clinton E.; Fong, Yuman.

In: Annals of Surgery, Vol. 237, No. 6, 06.2003, p. 860-870.

Research output: Contribution to journalArticle

Kooby, DA, Stockman, J, Ben-Porat, L, Gonen, M, Jarnagin, WR, Dematteo, RP, Tuorto, S, Wuest, D, Blumgart, LH, Fong, Y, Bolton, JS, Choti, MA, Clary, B, Baisden, CE & Fong, Y 2003, 'Influence of Transfusions on Perioperative and Long-Term Outcome in Patients Following Hepatic Resection for Colorectal Metastases', Annals of Surgery, vol. 237, no. 6, pp. 860-870. https://doi.org/10.1097/00000658-200306000-00015
Kooby, David A. ; Stockman, Jennifer ; Ben-Porat, Leah ; Gonen, Mithat ; Jarnagin, William R. ; Dematteo, Ronald P. ; Tuorto, Scott ; Wuest, David ; Blumgart, Leslie H. ; Fong, Yuman ; Bolton, John S. ; Choti, Michael A. ; Clary, Bryan ; Baisden, Clinton E. ; Fong, Yuman. / Influence of Transfusions on Perioperative and Long-Term Outcome in Patients Following Hepatic Resection for Colorectal Metastases. In: Annals of Surgery. 2003 ; Vol. 237, No. 6. pp. 860-870.
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abstract = "Objective: To determine if transfusion affected perioperative and long-term outcome in patients undergoing liver resection for metastatic colorectal cancer. Summary Background Data: Blood transfusion produces host immunosuppression and has been postulated to result in adverse outcome for patients undergoing surgical resection of malignancies. Methods: Blood transfusion records and clinical outcomes for 1,351 patients undergoing liver resection at a tertiary cancer referral center were analyzed. Results: Blood transfusion was a-ssociated n-with adverse outcome after liver resection. The greatest effect was in the perioperative course, where transfusion was an independent predictor of operative mortality, complications, major complications, and length of hospital stay. This effect was dose-related. Patients receiving one or two units or more than two units had an operative mortality of 2.5{\%} and 11.1{\%}, respectively, compared to 1.2{\%} for patients not requiring transfusions. Transfusion was also associated with adverse long-term survival by univariate analysis, but this factor was not significant on multivariate analysis. Even patients receiving only one or two units had a more adverse outcome. Conclusions: Perioperative blood transfusion is a risk factor for poor outcome after liver resection. Blood conservation methods should be used to avoid transfusion, especially in patents currently requiring limited amounts of transfused blood products.",
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AU - Kooby, David A.

AU - Stockman, Jennifer

AU - Ben-Porat, Leah

AU - Gonen, Mithat

AU - Jarnagin, William R.

AU - Dematteo, Ronald P.

AU - Tuorto, Scott

AU - Wuest, David

AU - Blumgart, Leslie H.

AU - Fong, Yuman

AU - Bolton, John S.

AU - Choti, Michael A.

AU - Clary, Bryan

AU - Baisden, Clinton E.

AU - Fong, Yuman

PY - 2003/6

Y1 - 2003/6

N2 - Objective: To determine if transfusion affected perioperative and long-term outcome in patients undergoing liver resection for metastatic colorectal cancer. Summary Background Data: Blood transfusion produces host immunosuppression and has been postulated to result in adverse outcome for patients undergoing surgical resection of malignancies. Methods: Blood transfusion records and clinical outcomes for 1,351 patients undergoing liver resection at a tertiary cancer referral center were analyzed. Results: Blood transfusion was a-ssociated n-with adverse outcome after liver resection. The greatest effect was in the perioperative course, where transfusion was an independent predictor of operative mortality, complications, major complications, and length of hospital stay. This effect was dose-related. Patients receiving one or two units or more than two units had an operative mortality of 2.5% and 11.1%, respectively, compared to 1.2% for patients not requiring transfusions. Transfusion was also associated with adverse long-term survival by univariate analysis, but this factor was not significant on multivariate analysis. Even patients receiving only one or two units had a more adverse outcome. Conclusions: Perioperative blood transfusion is a risk factor for poor outcome after liver resection. Blood conservation methods should be used to avoid transfusion, especially in patents currently requiring limited amounts of transfused blood products.

AB - Objective: To determine if transfusion affected perioperative and long-term outcome in patients undergoing liver resection for metastatic colorectal cancer. Summary Background Data: Blood transfusion produces host immunosuppression and has been postulated to result in adverse outcome for patients undergoing surgical resection of malignancies. Methods: Blood transfusion records and clinical outcomes for 1,351 patients undergoing liver resection at a tertiary cancer referral center were analyzed. Results: Blood transfusion was a-ssociated n-with adverse outcome after liver resection. The greatest effect was in the perioperative course, where transfusion was an independent predictor of operative mortality, complications, major complications, and length of hospital stay. This effect was dose-related. Patients receiving one or two units or more than two units had an operative mortality of 2.5% and 11.1%, respectively, compared to 1.2% for patients not requiring transfusions. Transfusion was also associated with adverse long-term survival by univariate analysis, but this factor was not significant on multivariate analysis. Even patients receiving only one or two units had a more adverse outcome. Conclusions: Perioperative blood transfusion is a risk factor for poor outcome after liver resection. Blood conservation methods should be used to avoid transfusion, especially in patents currently requiring limited amounts of transfused blood products.

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