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. 2022 Mar 30;20(1):100.
doi: 10.1186/s12957-022-02559-5.

Impact of perioperative blood transfusions on postoperative renal function and survival after resection of colorectal liver metastases

Wiebke Rodieck  1 , Michael Hallensleben  2 , Julia Robert  2 , Oliver Beetz  1 , Gerrit Grannas  1 , Sebastian Cammann  1 , Felix Oldhafer  1 , Juergen Klempnauer  1 , Florian W R Vondran  1 , Ulf Kulik  3
Affiliations

Impact of perioperative blood transfusions on postoperative renal function and survival after resection of colorectal liver metastases

Wiebke Rodieck et al. World J Surg Oncol. .

Abstract

Background and aims: Recent studies focusing on thoracic surgery suggest postoperative kidney injury depending on the amount of perioperative blood transfusions. Data investigating similar effects after resection of colorectal liver metastases (CRLM) are not available. Aim of this study was therefore to evaluate the influence of perioperative blood transfusions on postoperative renal function and survival after resection of CRLM.

Methods: Seven hundred twenty-seven cases of liver resection for CRLM were retrospectively analyzed. Renal function was measured via estimated glomerular filtration rate (eGFR) and a postoperative decline of ≥ 10% was considered substantial. Potential influences on postoperative kidney function were assessed using univariable and multivariable logistic regression analyses. Cox-regression analyses were performed to estimate the impact on overall survival (OS).

Results: Preoperative impaired kidney function (p = 0.001, OR 2.477) and transfusion of > 2 units of packed red blood cells (PRBC) (p = 0.046; OR 1.638) were independently associated with an increased risk for ≥ 10% loss of renal function. Neither a pre-existing renal impairment, nor the additional loss of renal function were associated with reduced survival. Chemotherapies in the context of primary colorectal cancer treatment (p = 0.002), age > 70 years at liver resection (p = 0.005), number (p = 0.001), and size of metastases > 50 mm (p = 0.018), duration of resection > 120 min (p = 0.006) and transfusions of > 2 units of PRBC (p = 0.039) showed a negative independent influence on OS.

Conclusion: The results demonstrate a negative impact of perioperative blood transfusions on the postoperative renal function and OS. Hence, efforts to reduce blood transfusions should be intensified.

Keywords: Colorectal cancer; Kidney function; Liver metastases; Liver resection; Transfusion.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Kaplan-Meier curve regarding survival after liver resection for CRLM depending on transfusion of > 2 PRBC. P < 0.001
See this image and copyright information in PMC

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