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Autologous blood donation in elective surgery of colorectal cancer - is it possible?

A. Todorov, A. Hadzhiev, B. Sakakushev, I. Ivanov, B. Atanasov

Abstract

Reports from recent studies indicate a causal relationship between all transfusion, infectious complications and recurrent disease in surgical patients. The aim of the presented study is to elucidate the possibilities and indications for autologous haemotransfusion in the elective surgery of the colorectal cancer. Retrospective analysis was per formed over 724 electively operated patients with colorectal cancer. The prospective part includes observation of 20 radically operated patients. In these patients autologous haemotransfusion was per - formed. As indications for autologous haemotransfusion we consider age up to 80 years, hemoglobin levels at least 130 g/l, plasma protein > 65 g/l, body weight > 50 kg, good general condition and absence of decompensated cardiovascular or endocrine dis eases. In two patients with hemoglobin level between 90 - 110 g/l we per formed stimulation by means of Erythropoietin. According to retrospective data ad mission hemoglobin levels varies from 54 g/l to 175 g/l (mean 119 g/l ± 22, 6). From all electively operated patients 33, 9% had hemoglobin values over 130 g/l. The frequency of post-operative infectious complications increases from 9.1% in non-transfused patients to 38,7 % in patients with more than 4 units of allogenic blood trans fused. The prospective part of the study is designed to establish feasibility of the autologous haemotransfusion in clinical practice. The fall of hemoglobin values on the next day after donation varies from 11g/l to 19g/l (mean 15.5 g/l ± 2,19). Erythropoietin stimulation was not found to increase hemoglobin values significantly. There were no complications in the post-operative period in autologous haemotransfusion group with exception of one superficial wound infection. Autologous haemotransfusion is feasible in approximately 1/3 of electively operated patients with colorectal cancer with no ad verse effects or post-operative complications. It de creases the necessity of allogenic bioproducts and hence the risks related. Autologous haemotransfusion is easy to perform and propose ben e fits both from medical and logistic nature. Concerning to stimulation with Erythropoetin in our opinion it is without proven short term efficacy in general surgery so far.

Keywords

colorectal cancer; autologous haemotransfusion; Erythropoetin

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References

Hod EA, Spitalnik SL. Harm ful ef fects of trans fu sion of older stored red blood cells: iron and in flam ma tion. Trans fu sion. 2011 Apr;51(4):881-5.

Mynster T, Christensen J, Moesgaard F, Nilsen J. Ef - fects of the com bi na tion of blood trans fu sion and post op er a tive in fec tious com pli ca tions on prog no sis af ter sur gery for colorectal can cer. Br J Surg 2000: 87 :1553-62

Chau JK, Har ris JR, Seikaly HR. Trans fu sion as a pre - dic tor of re cur rence and sur vival in head and neck can - cer sur gery pa tients. J Otolaryngol Head Neck Surg. 2010 Oct;39(5):516-22.

Ashworth A, Klein AA. Cell sal vage as part of a blood con ser va tion strat egy in an aes the sia. Br J Anaesth. 2010 Oct;105(4):401-16.

Bouchard D, Marcheix B, Al-Shamary S, Vanden Eynden F, Demers P, Robitaille D, Pellerin M, Perrault LP, Car rier M. Pre op er a tive autologous blood do na tion re duces the need for allogeneic blood prod ucts: a pro - spec tive ran dom ized study. Can J Surg. 2008 Dec;51(6):422-7.

Kinoshita Y, Harushi U, Kenji T et al. Use ful ness of autologous blood trans fu sion for avoid ing allogenic trans fu sion and in fec tious com pli ca tions af ter oe soph - ageal cancer resection. Sur gery: 2000 Feb; 127 (2), 185-192.

Vanderlinde E, Heal J, Blumberg N. Autologous trans fu sion. BMJ 2002; Vol 321:(3):722 - 5

Mar tin K, Keller E, Gertler R, Tassani P, Wiesner G. Ef - fi ciency and safety of pre op er a tive autologous blood do - na tion in car diac sur gery: a matched-pair anal y sis in 432 pa tients. Eur J Cardiothorac Surg. 2010 Jun;37(6):1396-401.

D. Damianov, Ò. Temelkov in “Prob lems in colorectal sur gery in Bul garia” 2001: p.18 and V. Dimitrov – in “Onkology” 2001; Siela: p. 423

Christodoulakis M, Tsiftsis DD. Pre op er a tive epoetin alfa in colorectal sur gery: a ran dom ized, con trolled study. Ann Surg Oncol. 2005 Sep;12(9):718-25.

Heiss MM, Tarabichi A, Delanoff C et all. Perisurgical erythropoetin ap pli ca tion in ane mic pa - tients with colorectal can cer. Sur gery 1996;May; 119 (5): 523-7




DOI: http://dx.doi.org/10.14748/ssm.v43i5.1182

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About The Authors

A. Todorov
Medical university of Plovdiv
Bulgaria

University hospital St. George, Clinic of general surgery with coloproctology

A. Hadzhiev
Medical university of Plovdiv
Bulgaria

University hospital St. George, Clinic of general surgery with coloproctology

B. Sakakushev
Medical university of Plovdiv
Bulgaria

University hospital St. George, Clinic of general surgery with coloproctology

I. Ivanov
Medical university of Plovdiv
Bulgaria

University hospital St. George, Clinic of general surgery with coloproctology

B. Atanasov
Medical university of Plovdiv
Bulgaria

University hospital St. George, Clinic of general surgery with coloproctology

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