Risk Factors and Complications of Transfusion Following Partial Nephrectomy

Area of Science:

• Urology
• Surgical Oncology
• Transfusion Medicine

Background:

• Partial nephrectomy (PN) is standard for small renal tumors, preserving kidney function.
• Postoperative bleeding and transfusion are significant risks following PN.
• Limited data exists on factors predicting transfusion in PN patients.

Purpose of the Study:

• To identify preoperative, perioperative, and postoperative variables associated with perioperative transfusion in patients undergoing PN.
• To assess the impact of transfusion on complication rates after PN.

Main Methods:

• Retrospective cohort study using the 2019-2020 American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database.
• Analysis of 892 patients undergoing PN, stratified by transfusion status.
• Univariate and multivariate logistic regression to identify transfusion predictors and outcomes.

Main Results:

• 13.0% of PN patients (116/892) required transfusion.
• Transfused patients were older and had higher rates of disseminated cancer, weight loss, bleeding disorders, and prior pelvic surgeries.
• Concomitant procedures (OR: 2.27), prior chemotherapy (OR: 4.89), and unplanned reoperation (OR: 6.16) were significant predictors of transfusion.
• Transfusion increased the odds of composite complications (OR: 1.20).

Conclusions:

• Preoperative and perioperative factors significantly influence transfusion risk in PN.
• Blood transfusion following PN is associated with increased complication rates.
• Optimized surgical planning, patient selection, and restrictive transfusion strategies may reduce morbidity.