Intraoperative Transfusion of Fresh Frozen Plasma Predicts Morbidity Following Partial Liver Resection for Hepatocellular Carcinoma

Elsevier BV - Tập 25 - Trang 1212-1223 - 2020
Jan Bednarsch1, Zoltan Czigany1, Isabella Lurje1, Christian Trautwein2, Tom Lüdde2, Pavel Strnad2, Nadine Therese Gaisa3, Alexandra Barabasch4, Philipp Bruners4, Tom Ulmer1, Sven Arke Lang1, Ulf Peter Neumann1,5, Georg Lurje1,6
1Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany
2Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
3Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany
4Department of Radiology, University Hospital RWTH Aachen, Aachen, Germany
5Department of Surgery, Maastricht University Medical Centre (MUMC), Maastricht, Netherlands
6Department of Surgery, Campus Charité Mitte | Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany

Tóm tắt

The reduction of perioperative morbidity is a main surgical goal in patients undergoing partial hepatectomy for hepatocellular carcinoma (HCC). Here, we investigated clinical determinants of perioperative morbidity in a European cohort of patients undergoing surgical resection for HCC. A total 136 patients who underwent partial hepatectomy for HCC between 2011 and 2017 at our institution were included in this analysis. The associations between major surgical complications (Clavien-Dindo ≥ 3) and overall morbidity (Clavien-Dindo ≥ 1) with clinical variables were assessed using univariate and multivariable binary logistic regression analysis. Multivariable analysis identified the Child-Pugh-Score (CPS, HR = 3.23; p = 0.040), operative time (HR = 5.63; p = 0.003), and intraoperatively administered fresh frozen plasma (FFP, HR = 5.62; p = 0.001) as independent prognostic markers of major surgical complications, while only FFP (HR = 6.52; p = 0.001) was associated with morbidity in the multivariable analysis. The transfusion of FFP was not associated with perioperative liver functions tests. The intraoperative administration of FFP is an important independent predictor of perioperative morbidity in patients undergoing partial hepatectomy for HCC.

Tài liệu tham khảo

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