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Excessive intraoperative blood loss independently predicts recurrence of hepatocellular carcinoma after liver transplantation
- Source :
- BMC Gastroenterology
- Publisher :
- Springer Nature
-
Abstract
- Background Several studies have investigated the effect of intraoperative blood loss (IBL) on recurrence of tumors. However, the independent effect of IBL on oncological outcome after liver transplantation (LT) for hepatocellular carcinoma (HCC) is unclear. Methods A total of 479 patients who underwent LT for HCC from January 2001 to December 2012 at our institution were enrolled in this retrospective study. Kaplan–Meier and Cox regression methods were used to assess the recurrence rate, as well as its risk factors. Stratified analysis was performed to further examine the effect of IBL on HCC recurrence according to different characteristics of tumors. We also investigated the independent risk factors for excessive IBL using logistic regression analysis. Results The median follow-up was 28 months (range, 1–131 months). Kaplan–Meier analysis with the log-rank test according to IBL at per liter intervals showed that IBL > 4 L was significantly associated with a higher recurrence rate (P 4 L (P 400 ng/mL, and micro- and macrovascular invasion. IBL > 4 L (P 4 L and vascular invasion (P = 0.019) was found. IBL > 4 L was independently associated with HCC recurrence for patients with vascular invasion, but not for patients without vascular invasion. Finally, we found that the presence of ascites, model for end-stage liver disease score, and operation time were independent risk factors for IBL > 4 L. Conclusions Excessive IBL is an independent predictor of HCC recurrence after LT, especially in patients with vascular invasion.
- Subjects :
- Adult
Male
medicine.medical_specialty
Carcinoma, Hepatocellular
Hepatocellular carcinoma
medicine.medical_treatment
Blood Loss, Surgical
Kaplan-Meier Estimate
Liver transplantation
Gastroenterology
Liver disease
Risk Factors
Recurrence
Internal medicine
Ascites
medicine
Carcinoma
Humans
Neoplasm Invasiveness
Aged
Proportional Hazards Models
Retrospective Studies
Aged, 80 and over
Proportional hazards model
business.industry
Liver Neoplasms
Age Factors
Retrospective cohort study
General Medicine
Middle Aged
Hepatology
medicine.disease
Surgery
Intraoperative blood loss
Female
alpha-Fetoproteins
Neoplasm Recurrence, Local
medicine.symptom
business
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 1471230X
- Volume :
- 15
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Gastroenterology
- Accession number :
- edsair.doi.dedup.....68b8f4512153a97977f69796dfe981e1
- Full Text :
- https://doi.org/10.1186/s12876-015-0364-5