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Meta-Analysis
. 2013 May 31;8(5):e64261.
doi: 10.1371/journal.pone.0064261. Print 2013.

Perioperative allogenenic blood transfusion is associated with worse clinical outcomes for hepatocellular carcinoma: a meta-analysis

Lei Liu  1 , Zhiwei Wang, Songqi Jiang, Bingfeng Shao, Jibing Liu, Suqing Zhang, Yilong Zhou, Yuan Zhou, Yixin Zhang
Affiliations
Meta-Analysis

Perioperative allogenenic blood transfusion is associated with worse clinical outcomes for hepatocellular carcinoma: a meta-analysis

Lei Liu et al. PLoS One. .

Abstract

Background and objective: The impact of perioperative allogenenic blood transfusion (ABT) on clinical outcomes for hepatocellular carcinoma (HCC) is conflicting and unclear. The aim of this meta-analysis is to evaluate the association between ABT and HCC clinical outcomes. Outcomes evaluated were all-cause death, tumor recurrence and postoperative complications.

Methods: Relevant articles were identified through MEDLINE search (up to November 2012). Meta-analyses were performed by using the fixed or random effect models. Study heterogeneity was assessed by Q-test and I(2) test. Publication bias was evaluated by funnel plots, Egger's and Begg's test.

Results: A total of 5635 cases from 22 studies finally met our inclusion criteria. Meta-analysis indicated HCC patients with ABT had an increased risk of all-cause death at 3 and 5 years after surgery (respectively: OR = 1.92, 95% CI, 1.61-2.29,P<0.001; OR = 1.60, 95% CI, 1.47-1.73,P<0.001 ) compared with those without ABT. The risk of tumor recurrence was significantly higher for ABT cases at 1, 3 and 5 years (respectively: OR = 1.70, 95% CI, 1.38-2.10, P<0.001; OR = 1.22, 95% CI, 1.08-1.38, P<0.001; OR = 1.16, 95% CI, 1.08-1.24, P<0.001). The HCC cases with ABT significantly increased postoperative complications occurrence compared with non-ABT cases (OR = 1.78,95% CI, 1.34-2.37, P<0.001).

Conclusions: The findings from the current meta-analysis demonstrated that ABT was associated with adverse clinical outcomes for HCC patients undergoing surgery, including increased death, recurrence and complications. Therefore, ABT should not be performed if possible.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow diagram of the selection and screening process for eligible studies.
Figure 2
Figure 2. Forest plot of postoperative death risk associated with ABT for HCC.
(A) for 3-year and (B) for 5-year. OR, odds ratio; CI, confidence interval.
Figure 3
Figure 3. Forest plot of postoperative recurrence risk associated with ABT for HCC.
(A) for 1-year, (B) for 3-year and (C) for 5-year. OR, odds ratio; CI, confidence interval.
Figure 4
Figure 4. Forest plot of postoperative complications risk associated with ABT for HCC.
OR, odds ratio; CI, confidence interval.
Figure 5
Figure 5. Funnel plot of publication bias test for ABT and HCC clinical outcomes.
Postoperative death at 3 year (upper left), postoperative death at 5 year (upper middle), postoperative recurrence at 1 year (upper right), postoperative recurrence at 3 year (lower left), postoperative recurrence at 5 year (lower middle), postoperative complications (lower right). Horizontal axis represents the log of OR; vertical axis represents SE of log(OR). CI, confidence interval; OR, odds ratio; Log, logarithm; SE, standard error.
See this image and copyright information in PMC

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