Tobias S. Schiergens, M.D.; Markus Rentsch, M.D.; Michael S. Kasparek, M.D. Katharina Frenes, M.D.; Karl-Walter Jauch, M.D.; Wolfgang E. Thasler, M.D.
The authors looked at factors associated with perioperative allogeneic red blood cell transfusion (ABT) and the effects of transfusion on recurrence-free survival (RFS) and overall survival (OS) after curative-intended resection of colorectal liver metastases. Analysis was done using retrospective data from 262 patients undergoing curative-intended liver resection for colorectal liver metastases. In their results, preoperative anemia, female sex, intraoperative blood loss and major postoperative complications were independent predictors of transfusion. Their findings were that after adjusting for confounders, perioperative ABT was independently associated with earlier disease recurrence, with larger quantities of transfusion having an even greater impact. Interestingly, neither major surgery nor greater blood loss increased the risk for earlier disease recurrence. This study showed a significant shortening of RFS with use of ABT, but even more significant it seems is the clear dose-dependent relationship between ABT and this adverse outcome. They make a strong case for implementation of PBM strategies to improve treatment and outcomes in this patient population.