Effects and correlative factors of perioperative fresh frozen plasma transfusion on complications after hepatectomy

Abstract

Objective To investigate the effects and correlative factors of perioperative fresh frozen plasma (FFP) transfusion on complications after hepatectomy. Methods Clinical data of 613 patients who underwent hepatectomy in the First Affiliated Hospital of Xi'an Jiaotong University between August 2009 and September 2015 were retrospectively analyzed. According to the patients received perioperative FFP transfusion or not, the patients were divided into the FFP transfusion group (FFP group, n=383) andnon-FFP transfusion group (control group, n=230). In the FFP group, 303 cases were males and 80 were females, aged (53.0±1.0) years old on average. In the control group, 173 cases were males and 57 were females, aged (53.0±1.0) years old on average. The informed consents of all patients were obtained and the local ethical committee approval was received. The patients were matched using propensity score matching (PSM) method, and the incidence of postoperative complications was compared using Chi-square test or Fisher's exact probability test. Clinical parameters of the patients were included as the influencing factors of FFP transfusion, and the correlation analysis was conducted using Logistic regression analysis. Results A total of 147 pairs of patients were matched using PSM method. After the patients were matched, the incidence of postoperative overall complications and peritoneal effusion in the FFP group was respectively 45.6% (67/147) and 31.3% (46/147), signifantly higher than 33.3% (49/147) and 15.6% (23/147) in the control group (χ2=4.61, 10.02; P 180 min, intraoperative blood loss >500 ml, the first hepatic portal occlusion, hemihepatectomy and major hepatectomy were the independent influencing factors of perioperative FFP transfusion (OR=3.14, 2.01, 1.76, 1.65, 1.85, 3.16, 1.62, 1.68; P<0.05). Conclusions Perioperative FFP transfusion can increase the incidence of peritoneal effusion after hepatectomy. Emaciation, poor tolerance to anesthesia, extensive surgical area and massive intraoperative blood loss are the pivotal factors of FFP transfusion. Key words: Hepatectomy; Perioperative period; Plasma; Postoperative complication