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Predictive factors for perioperative blood transfusions in partial nephrectomy for renal masses
Author(s) -
AbuGhanem Yasmin,
Dotan Zohar,
Kaver Issac,
Ramon Jacob
Publication year - 2015
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24029
Subject(s) - medicine , nephrectomy , perioperative , renal mass , blood transfusion , urology , surgery , kidney
Background Allogeneic perioperative blood transfusions (PBT) have been associated with higher rates of postoperative complications and tumour recurrence in a number of malignancies. This study evaluates the risk factors for PBT in patients undergoing partial nephrectomy (PN), in order to identify patients who could benefit from alternatives to allogenic blood. Methods Data on 822 patients who underwent elective PN between 1988 and 2013 were analysed. Patient demographics and clinicopathologic variables were collected retrospectively. PBT was defined as transfusion of allogeneic red blood cells during PN (in the operating‐room) or postoperative hospitalization. Results Of the 822 patients, 122 (14.8%) received PBT. Of these, 45.9% were transfused intraoperatively and 47.5% in the postoperative period. Only 14.3% of the patients who were transfused intraoperatively required additional postoperative transfusions. On multivariable analysis, age ≥65 ( P < 0.01), lower preoperative haemoglobin levels ( P < 0.001), larger renal masses ( P < 0.001), central lesions ( P < 0.01) and cumulative surgical experience ( P < 0.001) were found to be associated with higher rate of PBT. Conclusions Age, low preoperative haemoglobin level, lesion size, surgeons’ experience and central renal lesions are independent pre‐operative risk factors for PBT in patients undergoing PN. Evaluation of these risk factors prior to surgery may be helpful in constituting guidelines for a more responsible use of allogeneic blood and its alternatives. J. Surg. Oncol. 2015; 112:496–502 . © 2015 Wiley Periodicals, Inc.