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Effect of Intraoperative Red Blood Cell Transfusion on Postoperative Complications After Open Radical Cystectomy: Old Versus Fresh Stored Blood.

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Author(s)
Seung-Jun LeeHyungseok SeoHyun-Chang KimSeon-Min LimSo Jeong YoonHyung Suk KimJa Hyeon KuHee-Pyoung Park
Keimyung Author(s)
Kim, Hyun Chang
Department
Dept. of Anesthesiology & Pain Medicine (마취통증의학)
Journal Title
Clinical Genitourinary Cancer.
Issued Date
2015
Volume
13
Issue
6
Keyword
Blood storage durationBlood transfusionCystectomyPostoperative complications
Abstract
Transfusion is associated with adverse clinical outcomes. The effect of intraoperative transfusion with fresh
versus old blood on postoperative complications was compared in patients undergoing open radical cystectomy.
Intraoperative transfusion was predictive of postoperative complications. However, there was no
difference in the incidence of postoperative complications between transfusions with old blood and fresh
blood. Intraoperative transfusion per se, not the storage duration of red blood cells, was associated with
increased postoperative complications.
Introduction: Transfusion with red blood cells (RBCs) is associated with adverse clinical outcomes. We determined
whether an intraoperative RBC transfusion is related to postoperative complications in patients undergoing open
radical cystectomy. We also compared the effect of transfusion with fresh versus old blood on postoperative
complications. Patients and Methods: A total of 261 patients undergoing open radical cystectomy were divided into
no-transfusion or transfusion groups. Transfused patients were divided according to RBC storage duration (fresh,
14 days; old, > 14 days). Postoperative complications, such as infection, paralytic ileus, urinary tract obstruction,
and anastomotic leak, were noted. Results: Infection (26.5%) was the most common postoperative complication,
followed by procedural (17.6%), gastrointestinal (16.7%), renal (13.7%), and vascular (10.5%) problems. Age (odds
ratio [OR], 1.04; 95% confidence interval [CI], 1.00-1.07; P ¼ .029), urinary diversion with a neobladder (OR, 2.30; 95%
CI, 1.29-4.11; P ¼ .005), and intraoperative RBC transfusion (OR, 1.77; 95% CI, 1.02-3.07; P ¼ .042) were independent
predictors of postoperative complications in a binary logistic analysis. Patients (n ¼ 172; old blood, n ¼ 47; fresh
blood, n ¼ 116; mixed blood, n ¼ 9) who received an intraoperative RBC transfusion had a higher incidence of
postoperative complications than those (n ¼ 89) who did not undergo intraoperative transfusion (65.1% vs. 49.4%,
P < .05). No difference in the incidence of postoperative complications between transfusions with old blood and fresh
blood was observed (63.8% vs. 65.5%). Conclusion: Intraoperative RBC transfusion is associated with increased
postoperative complications in patients undergoing open radical cystectomy. The RBC storage duration may not
affect the incidence of postoperative complications in this study population.
Keimyung Author(s)(Kor)
김현창
Publisher
School of Medicine
Citation
Seung-Jun Lee et al. (2015). Effect of Intraoperative Red Blood Cell Transfusion on Postoperative Complications After Open Radical Cystectomy: Old Versus Fresh Stored Blood. Clinical Genitourinary Cancer., 13(6), 581–587. doi: 10.1016/j.clgc.2015.06.002
Type
Article
ISSN
1558-7673
Source
http://www.sciencedirect.com.proxy.dsmc.or.kr/science/article/pii/S1558767315001275?via%3Dihub
DOI
10.1016/j.clgc.2015.06.002
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32954
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
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