Packed red blood cell donor age affects overall survival in transfused patients undergoing hepatectomy for non-hepatocellular malignancy.

Autor: Loftus TJ; University of Florida College of Medicine, Department of Surgery, Gainesville, FL, USA., Lopez AN; University of Florida College of Medicine, Gainesville, FL, USA., Jenkins TK; University of Florida College of Medicine, Gainesville, FL, USA., Downey EM; LifeSouth Community Blood Centers, Gainesville, FL, USA., Sikora JR; University of Florida, Department of Pathology, Immunology, and Laboratory Medicine, Gainesville, FL, USA., Pelletier JPR; University of Florida, Department of Pathology, Immunology, and Laboratory Medicine, Gainesville, FL, USA., Zendejas IR; Intermountain Medical Center, Salt Lake City, UT, USA., Sarosi GA; University of Florida College of Medicine, Department of Surgery, Gainesville, FL, USA; North Florida/South Georgia Veterans Health System, Department of Surgery, Gainesville, FL, USA., Thomas RM; University of Florida College of Medicine, Department of Surgery, Gainesville, FL, USA; North Florida/South Georgia Veterans Health System, Department of Surgery, Gainesville, FL, USA. Electronic address: Ryan.Thomas@surgery.ufl.edu.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2019 Jan; Vol. 217 (1), pp. 71-77. Date of Electronic Publication: 2018 Aug 27.
DOI: 10.1016/j.amjsurg.2018.08.011
Abstrakt: Background: Patients undergoing hepatectomy often require packed red blood cell (PRBC) transfusion, which has been associated with worse oncologic outcomes. However, limited data exist regarding the impact of PRBC donor factors. We hypothesized that PRBC donor age impacts survival after hepatectomy for non-hepatocellular malignancies.
Methods: Patients who underwent hepatectomy for non-hepatocellular malignancy from 2005 to 2014 were retrospectively evaluated. Impact of clinicopathologic and PRBC factors on oncologic outcomes were assessed.
Results: Of 149 identified patients, 76 received a perioperative PRBC transfusion (median 2 units). Transfusion was associated with increased median length of stay (8 vs. 6 days; p < 0.01) and median operative blood loss (700 vs. 350 mL; p < 0.01) versus non-transfused, respectively. In transfused patients, receipt of PRBC from older donors compared to younger resulted in decreased RFS (0.94 vs. 2.63 years, respectively; p = 0.02) and OS (1.94 vs. 3.44 years, respectively; p = 0.6). The PRBC donor age was an independent predictor of decreased recurrence free survival on multivariate analysis (HR 2.5, p = 0.04).
Conclusions: In patients undergoing hepatectomy for non-hepatocellular malignancies and receiving perioperative transfusion, PRBC donor age may impact survival and warrants further investigation.
(Published by Elsevier Inc.)
Databáze: MEDLINE
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