Intraoperative autotransfusion in hepatic resection for malignancy. Is it safe?
R. A. Zulim, M. Rocco, J. E. Goodnight Jr, G. J. Smith, D. N. Krag and P. D. Schneider
Department of Surgery, University of California, Davis Cancer Center, Sacramento 95817.
To evaluate whether intraoperative autologous transfusion increases the
risk of hematogenous dissemination of tumor we reviewed the risk of lung
metastasis as well as disease-free and long-term survival of patients who
underwent resection of malignant hepatic neoplasms with this technique. A
retrospective review of patients undergoing liver resection for malignant
disease revealed 39 patients in whom intraoperative autologous transfusion
was used. The 2-year actuarial survival in the patients in this series, as
calculated with the Kaplan-Meier method, was predicted to be 75%. Two-year
actuarial disease-free survival was predicted to be 28%, and the risk of
developing lung metastasis at 3 years was estimated to be 40%. The
predicted overall survival and risk of recurrence in this series compare
favorably with published data for patients in whom intraoperative
autologous transfusion was not used.
