Blood salvage and autotransfusion during orthotopic liver transplantation for hepatocellular carcinoma: A systematic review and meta‐analysis

Author:

Hinojosa‐Gonzalez David E.1ORCID,Salgado‐Garza Gustavo1ORCID,Tellez‐Garcia Eduardo1ORCID,Escarcega‐Bordagaray Jaime A.1ORCID,Bueno‐Gutierrez Luis Carlos1ORCID,Madrazo‐Aguirre Katheryne1ORCID,Muñoz‐Hibert Monica I.1,Diaz‐Garza Karla G.1,Ramirez‐Mulhern Isabela1ORCID,Alvarez de la Reguera‐Babb Rodrigo1,Flores‐Villalba Eduardo12,Rodarte‐Shade Mario1ORCID,Gonzalez‐Urquijo Mauricio1ORCID

Affiliation:

1. Tecnologico de Monterrey School of Medicine and Health Sciences Monterrey Mexico

2. Tecnologico de Monterrey School of Engineering and Sciences Monterrey Mexico

Abstract

AbstractBackground:Hepatocellular carcinoma (HCC) is a significant cause of oncologic mortality worldwide. Liver transplantation represents a curative option for patients with significant liver dysfunction and absence of metastases. However, this therapeutic option is associated with significant blood loss and frequently requires various transfusions and intraoperative blood salvage for autotransfusion (IBS‐AT) with or without a leukocyte reduction filter. This study aimed to analyze available evidence on long‐term oncologic outcomes of patients undergoing liver transplantation for HCC with and without IBS‐AT.Methods:Per PRISMA guidelines, a systematic review of keywords “Blood Salvage,” “Auto‐transfusion,” “Hepatocellular carcinoma,” and “Liver‐transplant” was conducted in PubMed, EMBASE, and SCOPUS. Studies comparing operative and postoperative outcomes were screened and analyzed for review.Results:Twelve studies totaling 1704 participants were included for analysis. Length of stay, recurrence rates, and overall survival were not different between IBS‐AT group and non IBS‐AT group.Conclusion:IBS‐AT use is not associated with increased risk of recurrence in liver transplant for HCC even without leukocyte filtration. Both operative and postoperative outcomes are similar between groups. Comparison of analyzed studies suggest that IBS‐AT is safe for use during liver transplant for HCC.

Publisher

Wiley

Subject

Transplantation

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