Advantage of autologous blood transfusion in surgery for hepatocellular carcinoma

Table 1 Clinicopathological characteristics of patients of periods A and B with hepatocellular carcinoma

	Period A(1991-1994)	Period B(1995-2000)	P-value
	(n = 93)	(n = 201)
Clinical factors
Gender (male/female)	81/12	161/40	0.144
Age (yr)1	61 ± 9	62 ± 9	0.102
HBs-Ag (±)	73/20	169/32	0.243
Anti-HCV Ab (±/unknown)	29/62/2	71/125/5	0.471
Child-Pugh classification (A/B)	79/14	160/41	0.275
Preoperative Hb (g/dL)1	13.6 ± 1.5	13.3 ± 1.6	0.213
Tumor-related factors
Number of tumors (single/multiple)	70/23	146/55	0.635
Maximum tumor size (cm)1	3.8 ± 2.7	4.1 ± 3.1	0.450
Vascular invasion (±)	83/10	172/29	0.388
Histological grade (I, II/III, IV/unknown)	40/41/12	89/92/20	0.975
Surgery-related factors
Procedure (nonanatomical/anatomical)	45/48	101/100	0.767
Operation time (min)1	291 ± 144	295 ± 151	0.853
Resected liver volume (g)1	218 ± 406	214 ± 289	0.925
Intraoperative blood loss (mL)1	2190 ± 5689	1621 ± 2209	0.219

¹Data are expressed as number of patients and mean ± standard deviation. HBs-Ag: Hepatitis B surface antigen; Anti-HCV Ab: Anti-hepatic C virus antibody; Hb: Hemoglobin.

Table 2 Clinicopathological characteristics of patients with hepatocellular carcinoma according to homologous blood transfusion

	Non-HT group	HT group	P-value
	(n = 200)	(n = 94)
Clinical factors
Gender (male/female)	162/38	80/14	0.390
Age (yr)1	62 ± 9	60 ± 9	0.084
HBs-Ag (±)	168/32	74/20	0.269
Anti-HCV Ab (±/unknown)	65/130/5	35/57/2	0.437
Child-Pugh classification (A/B)	167/33	72/22	0.157
Preoperative Hb (g/dL)1	13.5 ± 1.6	13.2 ± 1.7	0.171
AT administration (±)	82/118	78/16	< 0.0001
Tumor-related factors
Number of tumors (single/multiple)	149/51	67/27	0.559
Maximum tumor size (cm)1	3.6 ± 2.4	4.9 ± 3.7	0.000
Vascular invasion (±)	177/23	78/16	0.193
Histological grade (I, II/III, IV/unknown)	91/88/21	38/45/11	0.446
Surgery-related factors
Procedure (nonanatomical/anatomical)	111/89	35/59	0.004
Operation time (min)1	264 ± 130	356 ± 166	< 0.0001
Resected liver volume (g)1	159 ± 196	336 ± 490	< 0.0001
Intraoperative blood loss (mL)1	993 ± 707	3522 ± 6104	< 0.0001

¹Data are expressed as number of patients and mean ± standard deviation. HBs-Ag: Hepatitis B surface antigen; Anti-HCV Ab: Anti-hepatic C virus antibody; Hb: Hemoglobin; AT: Autologous transfusion; HT: Homologous transfusion.

Table 3 Results of multivariate logistic regression analysis for the need for homologous blood transfusion

		OR	95% CI	P-value
AT administration	±	28.571	9.615-83.333	< 0.0001
Maximum tumor size (cm)	< 5/≥ 5	1.126	0.500-2.538	0.774
Procedure	Nonanatomical/anatomical	1.016	0.449-2.202	0.967
Operation time (min)	< 300/≥ 300	0.986	0.435-2.242	0.974
Resected liver volume (g)	< 200/≥ 200	2.532	1.062-6.061	0.036
Intraoperative blood loss (mL)	< 2000/≥ 2000	30.303	9.346-100.000	< 0.0001

OR: Odds ratio; CI: Confidence interval; AT: Autologous transfusion.

Table 4 Clinicopathological characteristics of patients who underwent curative surgery for hepatocellular carcinoma

	Non-HT group	HT group(n = 83)	P-value(Non-HT vs HT)	Non-HT group
	(n = 193)			Non-transfusion group(n = 78)	AT group(n = 115)	P-value(Non-transfusion vs AT)
Clinical factors
Gender (male/female)	156/37	70/13	0.488	63/15	93/22	0.986
Age (yr)1	62 ± 8	61 ± 9	0.115	62 ± 8	61 ± 9	0.878
HBs-Ag (±)	163/30	67/16	0.445	Nov-67	96/19	0.649
Anti-HCV Ab (±/unknown)	62/127/4	31/51/1	0.426	21/54/3	41/73/1	0.254
Child-Pugh classification (A/B)	161/32	65/18	0.262	66/12	95/20	0.833
Preoperative Hb (g/dL)1	13.5 ± 1.5	13.4 ± 1.6	0.425	12.8 ± 1.8	14.1 ± 1.1	< 0.0001
Tumor-related factors
Number of tumors (single/multiple)	147/46	64/19	0.866	62/16	85/30	0.372
Maximum tumor size (cm)1	3.5 ± 2.4	4.8 ± 3.7	0.000	3.3 ± 2.2	3.6 ± 2.4	0.287
Vascular invasion (±)	172/21	70/13	0.268	73/5	99/16	0.101
Histological grade (I, II/III, IV/unknown)	89/83/21	33/41/9	0.304	36/34/8	53/49/13	0.412

¹Data are expressed as number of patients and mean ± standard deviation. HBs-Ag: Hepatitis B surface antigen; Anti-HCV Ab: Anti-hepatic C virus antibody; Hb: Hemoglobin; AT: Autologous transfusion; HT: Homologous transfusion.

Table 5 Statistical analysis of disease-free survival of patients with curative resection for hepatocellular carcinoma

	Univariate	Multivariate
	P-value	OR	95% CI	P-value
Clinical factors
Gender (male/female)	0.840
Age (yr) ( ≤ 63/> 63)	0.402
HBs-Ag (±)	0.279
Anti-HCV Ab (±)	0.045	1.401	1.032-1.901	0.031
Child-Pugh classification (A/B)	0.079
Preoperative Hb (g/dL)	0.824
( ≤ 12/> 12)
Transfusion (non-HT group/HT group)	0.031	1.372	1.018-1.849	0.038
Tumor-related factors
Number of tumors (single/multiple)	0.000	1.819	1.290-2.564	0.001
Maximum tumor size (cm)	0.001	1.07	0.750-1.525	0.709
( ≤ 5/> 5)
Vascular invasion (±)	< 0.0001	2.473	1.606-3.806	< 0.0001
Histological grade (I, II/III, IV)	0.017	1.188	0.898-1.570	0.227

OR: Odds ratio; CI: Confidence interval; HBs-Ag: Hepatitis B surface antigen; Anti-HCV Ab: Anti-hepatic C virus antibody; Hb: Hemoglobin; HT: Homologous transfusion.