Fresh frozen plasma transfusion does not affect outcomes following hepatic resection for hepatocellular carcinoma

Table 1 Comparison of perioperative characteristics between Group A (1983-1993) and Group B (1998-2006), and between Group B1 and Group B2 n (%)

	Group A (1983-1993) (n = 204)	Group B (1998-2006) (n = 297)	P-value	Group B		P-value
				Group B1 (n = 22)	Group B2 (n = 275)
Age (yr)
< 60	114 (55.9)	207 (69.7)	0.0015	9 (40.9)	81 (29.5)	NS
≥ 60	90 (44.1)	90 (30.3)		13 (59.1)	194 (70.5)
Gender
Male	178 (87.3)	235 (79.1)	0.0188	20 (90.9)	215 (78.2)	NS
Female	26 (12.7)	62 (20.9)		2 (9.1)	60 (21.8)
Child-Pugh
A	187 (91.7)	251 (84.5)	0.0176	17 (77.3)	234 (85.1)	NS
B	17 (8.3)	46 (15.5)		5 (22.7)	41 (14.9)
Viral infection
HBV (+)	40/201 (19.9)	56 (18.9)	NS	4 (18.2)	52 (18.9)	NS
HCV (+)	47/78 (60.3)	177 (59.6)	NS	11 (40.9)	166 (61.1)	NS
Surgical procedure
≤ Hr1	171 (83.8)	241 (81.1)	NS	14 (63.6)	227 (82.5)	0.0436
≥ Hr2	33 (16.2)	56 (18.9)		8 (36.4)	48 (17.5)
Intraoperative blood loss (mL)
< 2000	133 (65.2)	247 (83.2)	< 0.0001	1 (4.5)	246 (89.5)	< 0.0001
≥ 2000	71 (34.8)	50 (16.8)		21 (95.5)	29 (10.5)
Use of FFP
(-)	0 (0)	275 (92.6)	< 0.0001
(+)	204 (100.0)	22 (7.4)
Mortality	8 (3.9)	0 (0)	0.0007	0 (0)	0 (0)	--
Morbidity	55 (27.0)	73 (24.6)	NS	9 (40.9)	64 (23.2)	NS

HBV: Hepatitis B virus; HCV: Hepatitis C virus; ≤ Hr1: Partial resection, subsegmentectomy, and segmentectomy of the liver; ≥ Hr2: Bisegmentectomy or more; FFP: Fresh frozen plasma; NS: Not significant.

Table 2 Comparison of perioperative characteristics between Group B1_{≥ 2000 mL} and Group B2_{≥ 2000 mL}n (%)

	Group B1≥ 2000 mL (n = 21)	Group B2≥ 2000 mL (n = 29)	P-value
Age (yr)
< 60	9 (42.9)	11 (37.9)	NS
≥ 60	12 (57.1)	18 (62.1)
Gender
Male	20 (95.2)	23 (79.3)	NS
Female	1 (4.8)	6 (20.7)
Child-Pugh
A	17 (81.0)	21 (72.4)	NS
B	4 (19.0)	8 (27.6)
Viral infection
HBV (+)	5 (23.8)	3 (10.3)	NS
HCV (+)	9 (42.9)	19 (65.5)	NS
Maximum size of tumor(s) (cm)	8.3 ± 6.3	6.9 ± 4.6	NS
Intrahepatic metastasis
(-)	9 (26.8)	17 (58.6)	NS
(+)	12 (63.2)	12 (41.4)
Vascular involvement
(-)	8 (38.1)	17 (58.6)	NS
(+)	13 (61.9)	12 (41.4)
Operative time (min)	426 ± 154	391 ± 130	NS
Intraoperative blood loss (mL)	5364 ± 1651	2854 ± 1056	< 0.0001
Use of RCC
(-)	3 (14.3)	19 (65.5)	0.0004
(+)	18 (85.7)	10 (34.5)
Surgical procedure
≤ Hr1	14 (66.7)	17 (58.6)	NS
≥ Hr2	7 (33.3)	12 (41.4)

HBV: Hepatitis B virus; HCV: Hepatitis C virus; ≤ Hr1: Partial resection, subsegmentectomy, and segmentectomy of the liver; ≥ Hr2: Bisegmentectomy or more; RCC: Red cell concentrate; NS: Not significant.

Table 3 Comparison of postoperative complications between Group B1_{≥ 2000 mL} and Group B2_{≥ 2000 mL}n (%)

	Group B1≥ 2000 mL (n = 21)	Group B2≥ 2000 mL (n = 29)	P-value
Mortality	0 (0)	0 (0)	--
Morbidity	9 (42.9)	9 (31.0)	NS
Cardiopulmonary	2 (9.5)	0 (0)
Renal dysfunction	0 (0)	0 (0)
Hepatic failure	0 (0)	0 (0)
Bleeding	1 (4.8)	1 (3.4)
Bile leakage	1 (4.8)	2 (6.9)
Ascites and/or pleural effusion	0 (0)	3 (10.3)
Ileus	2 (9.5)	0 (0)
Wound infection	3 (14.3)	3 (10.3)

NS: Not significant.

Table 4 Multivariate analysis of disease-free survival and overall survival after hepatectomy for hepatocellular carcinoma in patients with intraoperative blood loss of ≥ 2000 mL

	n	DFS			OS
		OR	95% CI	P-value	OR	95% CI	P-value
Maximum size of tumor (cm)		1.553	0.755-3.191	NS
≤ 5	16
> 5	31
Tumor number					2.280	0.874-5.591	NS
Single	24
Multiple	26
Vascular invasion		2.445	1.091-5.464	0.0299	3.203	1.216-8.439	0.0185
(-)	25
(+)	25
RCC transfusion		1.695	0.674-4.261	NS
(-)	22
(+)	28
FFP transfusion		1.340	0.512-3.005	NS
(-)	29
(+)	21

DFS: Disease-free survival; OS: Overall survival; OR: Odds ratio; 95% CI: 95% confidence interval; RCC: Red cell concentrate; FFP: Fresh frozen plasma; NS: Not significant.