Impact of blood transfusion on early outcome of liver resection for colorectal hepatic metastases

Abstract

The use of intra-operative blood transfusion has been associated with worse surgical outcome in patients undergoing liver resection for malignancy. In a series of 127 consecutive patients who underwent partial liver resection for colorectal metastases, between July 1999 and March 2010, we studied, post-operative 90 days surgical outcome using Clavien multi-tier grading system, and the effect of a variety of related factors, including type of resection, surgical technique used, concomitant colo-rectal resection, non-tumoral hepatic histological findings, site of primary tumor, and comorbidities, on the incidence of intra-operative blood transfusion. Patients who received blood transfusions during their liver resection were more likely to have a longer post-operative length of stay, to experience Clavien Grade IIIa or worse complication. Undergoing a major resection and the presence of portal fibrosis in the non-tumoral liver tissue were both correlated with an increase in intra-operative blood transfusions. These clinical findings suggest that although several significant factors do not seem to influence the short-term outcome of surgery, it is important to be aware of the deleterious effects of the type of resection performed and the presence of portal fibrosis on blood loss during partial liver resection.