Perioperative allogenenic blood transfusion is associated with worse clinical outcomes for hepatocellular carcinoma: a meta-analysis

• Published in: PloS one Vol. 8; no. 5; p. e64261
• Main Authors: Liu, Lei, Wang, Zhiwei, Jiang, Songqi, Shao, Bingfeng, Liu, Jibing, Zhang, Suqing, Zhou, Yilong, Zhou, Yuan, Zhang, Yixin
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 31.05.2013; Public Library of Science (PLoS)
• Subjects: Aged; Allografts; Blood; Blood products; Blood Transfusion; Blood transfusions; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - surgery; Carcinoma, Hepatocellular - therapy; Clinical outcomes; Colorectal cancer; Complications; Contraindications; Databases, Bibliographic; Death; Female; Hepatocellular carcinoma; Hospitals; Humans; Ligands; Liver cancer; Liver cirrhosis; Liver Neoplasms - mortality; Liver Neoplasms - surgery; Liver Neoplasms - therapy; Male; Mathematics; Medical ethics; Medical prognosis; Medicine; Meta-analysis; Middle Aged; Mortality; Neural networks; Patients; Perioperative Care; Recurrence; Studies; Surgery; Survival Analysis; Systematic review; Transfusion; Treatment Outcome; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0064261

The impact of perioperative allogenenic blood transfusion (ABT) on clinical outcomes for hepatocellular carcinoma (HCC) is conflicting and unclear. The aim of this meta-analysis is to evaluate the association between ABT and HCC clinical outcomes. Outcomes evaluated were all-cause death, tumor recurrence and postoperative complications. Relevant articles were identified through MEDLINE search (up to November 2012). Meta-analyses were performed by using the fixed or random effect models. Study heterogeneity was assessed by Q-test and I(2) test. Publication bias was evaluated by funnel plots, Egger's and Begg's test. A total of 5635 cases from 22 studies finally met our inclusion criteria. Meta-analysis indicated HCC patients with ABT had an increased risk of all-cause death at 3 and 5 years after surgery (respectively: OR = 1.92, 95% CI, 1.61-2.29,P<0.001; OR = 1.60, 95% CI, 1.47-1.73,P<0.001 ) compared with those without ABT. The risk of tumor recurrence was significantly higher for ABT cases at 1, 3 and 5 years (respectively: OR = 1.70, 95% CI, 1.38-2.10, P<0.001; OR = 1.22, 95% CI, 1.08-1.38, P<0.001; OR = 1.16, 95% CI, 1.08-1.24, P<0.001). The HCC cases with ABT significantly increased postoperative complications occurrence compared with non-ABT cases (OR = 1.78,95% CI, 1.34-2.37, P<0.001). The findings from the current meta-analysis demonstrated that ABT was associated with adverse clinical outcomes for HCC patients undergoing surgery, including increased death, recurrence and complications. Therefore, ABT should not be performed if possible.