During liver transplantation in HCC patients Intraoperative Blood Salvage safe and effective

The effects of intraoperative blood salvage (IBS) on time to tumour recurrence, disease-free survival and overall survival in hepatocellular carcinoma (HCC) patients undergoing liver transplantation were assessed to evaluate the safety of IBS.

IBS is highly effective to reduce the use of allogeneic blood transfusion. However, the safety of IBS during liver transplantation for patients with HCC is questioned due to fear of disseminating malignant cells.

Comprehensive searches through June 2021 were performed in 8 databases. The methodological quality of included studies was assessed using the Robins-I tool. Meta-analysis with the generic inverse variance method was performed to calculate pooled hazard ratios (HRs) for disease-free survival, HCC recurrence and overall survival.

Results:

• Nine studies were included.
• Use of IBS during liver transplantation was not associated with impaired disease-free survival not associated with increased HCC recurrence and not associated with impaired overall survival

Based on available observational data, the use of IBS during liver transplantation in patients with HCC does not result in impaired disease-free survival, increased HCC recurrence or impaired overall survival. Therefore, the use of IBS during liver transplantation for HCC patients is a safe procedure.

Reference:

Aijtink, Virginia J. MD*; Rutten, Vera C. MD*; Meijer, Beatrice E.M. MD*; de Jong, Renate MD, PhD†; Isaac, John L. MD‡; Polak, Wojciech G. MD, PhD*; Perera, M. Thamara P.R. MD, FRCS§,∥; Sneiders, Dimitri MD, PhD*,§; Hartog, Hermien MD, PhD§,∥. Safety of Intraoperative Blood Salvage During Liver Transplantation in Patients With Hepatocellular Carcinoma: A Systematic Review and Meta-analysis. Annals of Surgery: August 2022 - Volume 276 - Issue 2 - p 239-245

doi: 10.1097/SLA.0000000000005476

Keywords:

Aijtink, Virginia J, Rutten, Vera C. Meijer, Beatrice E.M. de Jong, Renate Isaac, John L. Polak, Wojciech Perera, M. Thamara P.R. MD, FRCS§,∥; Sneiders, Dimitri Hartog, Hermien, Safety, Intraoperative Blood, Salvage, Liver, Transplantation, Patients, Hepatocellular, Carcinoma, Systematic, Review, Meta-analysis, Annals of Surgery