Oncologic Outcomes of Intraoperative Autologous Blood Transfusion for Major Oncologic Resection

Area of Science:

• Oncology
• Transfusion Medicine
• Surgical Oncology

Background:

• Intraoperative autologous blood transfusion (IABT) is often contraindicated in oncologic resections due to concerns about promoting cancer metastasis.
• Limited data exists to support or refute the claim that IABT increases cancer recurrence risk.

Purpose of the Study:

• To evaluate the association between IABT and early metastasis in patients undergoing oncologic resection.
• To assess the safety and efficacy of IABT compared to allogeneic transfusions in specific cancer patient subgroups, such as liver transplant recipients.

Main Methods:

• Retrospective analysis of 444 patients who underwent oncologic resection with IABT between 2010-2021.
• Primary outcome was early distant metastasis. Subgroup analysis used inverse probability of treatment weighting to compare survival in liver transplant patients receiving autologous versus allogeneic transfusions.

Main Results:

• The most common diagnoses included hepatocellular carcinoma, cholangiocarcinoma, and renal cell carcinoma.
• Only one of seven patients with early distant recurrence (within 90 days) had metastasis not attributable to preoperative factors.
• In liver transplant recipients, IABT was not associated with overall survival (AHR 1.30, P=0.241) or recurrence-free survival (AHR 1.15, P=0.498) after adjustment.

Conclusions:

• Intraoperative autologous blood transfusion does not appear to be linked to early cancer recurrence after oncologic resection.
• IABT warrants further investigation as a potential alternative to allogeneic blood transfusions in major oncologic surgeries.