Brief Article
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World J Gastroenterol. Nov 28, 2010; 16(44): 5603-5610
Published online Nov 28, 2010. doi: 10.3748/wjg.v16.i44.5603
Fresh frozen plasma transfusion does not affect outcomes following hepatic resection for hepatocellular carcinoma
Yoshito Tomimaru, Hiroshi Wada, Shigeru Marubashi, Shogo Kobayashi, Hidetoshi Eguchi, Yutaka Takeda, Masahiro Tanemura, Takehiro Noda, Koji Umeshita, Yuichiro Doki, Masaki Mori, Hiroaki Nagano
Yoshito Tomimaru, Hiroshi Wada, Shigeru Marubashi, Shogo Kobayashi, Hidetoshi Eguchi, Yutaka Takeda, Masahiro Tanemura, Takehiro Noda, Yuichiro Doki, Masaki Mori, Hiroaki Nagano, Department of Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan
Koji Umeshita, Division of Health Sciences, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan
Author contributions: Tomimaru Y was responsible for the review of the literature and initial preparation of the paper; Wada H, Marubashi S, Kobayashi S, Eguchi H, Takeda Y, Tanemura M, Noda T and Umeshita K contributed to the data collection; Doki Y, Mori M and Nagano H prepared the final version of the manuscript.
Correspondence to: Hiroaki Nagano, MD, PhD, Department of Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka E-2, Suita, 565-0871, Osaka, Japan. hnagano@gesurg.med.osaka-u.ac.jp
Telephone: +81-6-68793251 Fax: +81-6-68793259
Received: May 7, 2010
Revised: June 28, 2010
Accepted: July 5, 2010
Published online: November 28, 2010
Abstract

AIM: To investigate whether fresh frozen plasma (FFP) transfusion affects outcomes following hepatic resection for hepatocellular carcinoma (HCC) in terms of liver function, postoperative complications and cancer prognosis.

METHODS: We retrospectively compared the incidence of postoperative complications between 204 patients who underwent hepatectomy for HCC with routine FFP transfusion in an early period (1983-1993, Group A) and 293 with necessity for FFP transfusion during a later period (1998-2006, Group B), and also between two subgroups of Group B [22 patients with FFP transfusion (Group B1) and 275 patients without FFP transfusion (Group B2)]. Additionally, only in limited patients in Group B1 and Group B2 with intraoperative blood loss ≥ 2000 mL (Group B1≥ 2000 mL and Group B2≥ 2000 mL), postoperative complications, liver function tests, and cancer prognosis were compared.

RESULTS: No mortality was registered in Group B, compared to 8 patients (3.9%) of Group A. The incidence of morbidity in Group B2 [23.2% (64/275)] was not significantly different from Group B1 [40.9% (9/22)] and Group A [27.0% (55/204)]. The incidence of complications and postoperative liver function tests were comparable between Group B1≥ 2000 mLvs Group B2≥ 2000 mL. Postoperative prognosis did not correlate with administration of FFP, but with tumor-related factors.

CONCLUSION: The outcome of hepatectomy for HCC is not influenced by FFP transfusion. We suggest FFP transfusion be abandoned in patients who undergo hepatectomy for HCC.

Keywords: Fresh frozen plasma; Hepatocellular carcinoma; Surgery; Transfusion