AUTOLOGOUS BLOOD-TRANSFUSION FOR HEPATECTOMY IN PATIENTS WITH CIRRHOSIS AND HEPATOCELLULAR-CARCINOMA - USE OF RECOMBINANT-HUMAN-ERYTHROPOIETIN

Background. We evaluated the benefit of autologous blood transfusion and the effect of recombinant human erythropoietin (rh-EPO) on preoperative autologous blood donation for hepatectomy in patients with cirrhosis. Methods. Forty-two patients with cirrhosis and hepatocellular carcinoma underwent hepatectomy, 21 of whom (group A) donated autologous blood before operation. Eleven of these patients (group A(1)) were administered rh-EPO before operation, and ten patients (group A(2)) were untreated. Twenty-one patients (group B) did not donate autologous blood. Results. The frequency of homologous blood transfusion was 24% in group A and 62% in group B (p < 0.05). Preoperative erythropoiesis increased markedly in group A1, and postoperative erythropoietin production was not suppressed in this group. Postoperative hematocrits recovred significantly more rapidly in patietns transfused with only autologous blood. Postoperative serum total bilirubin concentrations were significantly higher in patietns with transfused homologous blood. Conclusions. Autologous blood transfusion yields clinically superior results for hepatectomy in patients with cirrhosis when compared with homologous transfusion. Preoperative rh-EPO administration minimizes presurgical decreases in hematocrit caused by autologous blood donation.