Clinical prognosis of intraoperative blood salvage autotransfusion in liver transplantation for hepatocellular carcinoma: A systematic review and meta-analysis
BackgroundIntraoperative blood salvage autotransfusion(IBSA) has been widely used in a variety of surgeries, but the use of IBSA in hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT) is controversial. Numerous studies have reported that IBSA used during LT for HCC is not a...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.985281/full |
| _version_ | 1828219876385226752 |
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| author | Zheng Wang Saixin Li Yitong Jia Miao Liu Kun Yang Minghao Sui Dongbin Liu Kuo Liang |
| author_facet | Zheng Wang Saixin Li Yitong Jia Miao Liu Kun Yang Minghao Sui Dongbin Liu Kuo Liang |
| author_sort | Zheng Wang |
| collection | DOAJ |
| description | BackgroundIntraoperative blood salvage autotransfusion(IBSA) has been widely used in a variety of surgeries, but the use of IBSA in hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT) is controversial. Numerous studies have reported that IBSA used during LT for HCC is not associated with adverse oncologic outcomes. This systematic review and meta-analysis aims to estimate the clinical prognosis of IBSA for patients with H+CC undergoing LT.MethodsMEDLINE, Embase, Web of Science, and Cochrane Library were searched for articles describing IBSA in HCC patients undergoing LT from the date of inception until May 1, 2022, and a meta-analysis was performed. Study heterogeneity was assessed by I2 test. Publication bias was evaluated by funnel plots, Egger’s and Begg’s test.Results12 studies enrolling a total of 2253 cases (1374 IBSA and 879 non-IBSA cases) are included in this meta-analysis. The recurrence rate(RR) at 5-year(OR=0.75; 95%CI, 0.59-0.95; P=0.02) and 7-year(OR=0.65; 95%CI, 0.55-0.97; P=0.03) in the IBSA group is slightly lower than non-IBSA group. There are no significant differences in the 1-year RR(OR=0.77; 95% CI, 0.56-1.06; P=0.10), 3-years RR (OR=0.79; 95% CI, 0.62-1.01; P=0.06),1-year overall survival outcome(OS) (OR=0.90; 95% CI, 0.63-1.28; P=0.57), 3-year OS(OR=1.16; 95% CI, 0.83-1.62; P=0.38), 5-year OS(OR=1.04; 95% CI, 0.76-1.40; P=0.82),1-year disease-free survival rate(DFS) (OR=0.80; 95%CI, 0.49-1.30; P=0.36), 3-year DFS(OR=0.99; 95%CI, 0.64-1.55; P=0.98), and 5-year DFS(OR=0.88; 95%CI, 0.60-1.28; P=0.50). Subgroup analysis shows a difference in the use of leukocyte depletion filters group of 5-year RR(OR=0.73; 95%CI, 0.55-0.96; P=0.03). No significant differences are found in other subgroups.ConclusionsIBSA provides comparable survival outcomes relative to allogeneic blood transfusion and does not increase the tumor recurrence for HCC patients after LT.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022295479. |
| first_indexed | 2024-04-12T16:20:37Z |
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| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-12T16:20:37Z |
| publishDate | 2022-10-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-0baa753ee57a4664823f07664f5f7fe62022-12-22T03:25:34ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-10-011210.3389/fonc.2022.985281985281Clinical prognosis of intraoperative blood salvage autotransfusion in liver transplantation for hepatocellular carcinoma: A systematic review and meta-analysisZheng Wang0Saixin Li1Yitong Jia2Miao Liu3Kun Yang4Minghao Sui5Dongbin Liu6Kuo Liang7Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Evidence-Based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaBackgroundIntraoperative blood salvage autotransfusion(IBSA) has been widely used in a variety of surgeries, but the use of IBSA in hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT) is controversial. Numerous studies have reported that IBSA used during LT for HCC is not associated with adverse oncologic outcomes. This systematic review and meta-analysis aims to estimate the clinical prognosis of IBSA for patients with H+CC undergoing LT.MethodsMEDLINE, Embase, Web of Science, and Cochrane Library were searched for articles describing IBSA in HCC patients undergoing LT from the date of inception until May 1, 2022, and a meta-analysis was performed. Study heterogeneity was assessed by I2 test. Publication bias was evaluated by funnel plots, Egger’s and Begg’s test.Results12 studies enrolling a total of 2253 cases (1374 IBSA and 879 non-IBSA cases) are included in this meta-analysis. The recurrence rate(RR) at 5-year(OR=0.75; 95%CI, 0.59-0.95; P=0.02) and 7-year(OR=0.65; 95%CI, 0.55-0.97; P=0.03) in the IBSA group is slightly lower than non-IBSA group. There are no significant differences in the 1-year RR(OR=0.77; 95% CI, 0.56-1.06; P=0.10), 3-years RR (OR=0.79; 95% CI, 0.62-1.01; P=0.06),1-year overall survival outcome(OS) (OR=0.90; 95% CI, 0.63-1.28; P=0.57), 3-year OS(OR=1.16; 95% CI, 0.83-1.62; P=0.38), 5-year OS(OR=1.04; 95% CI, 0.76-1.40; P=0.82),1-year disease-free survival rate(DFS) (OR=0.80; 95%CI, 0.49-1.30; P=0.36), 3-year DFS(OR=0.99; 95%CI, 0.64-1.55; P=0.98), and 5-year DFS(OR=0.88; 95%CI, 0.60-1.28; P=0.50). Subgroup analysis shows a difference in the use of leukocyte depletion filters group of 5-year RR(OR=0.73; 95%CI, 0.55-0.96; P=0.03). No significant differences are found in other subgroups.ConclusionsIBSA provides comparable survival outcomes relative to allogeneic blood transfusion and does not increase the tumor recurrence for HCC patients after LT.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022295479.https://www.frontiersin.org/articles/10.3389/fonc.2022.985281/fullhepatocellular carcinomaintraoperative blood salvage autotransfusionliver transplantationleukocyte depletion filterstreatment outcomemeta-analysis. |
| spellingShingle | Zheng Wang Saixin Li Yitong Jia Miao Liu Kun Yang Minghao Sui Dongbin Liu Kuo Liang Clinical prognosis of intraoperative blood salvage autotransfusion in liver transplantation for hepatocellular carcinoma: A systematic review and meta-analysis Frontiers in Oncology hepatocellular carcinoma intraoperative blood salvage autotransfusion liver transplantation leukocyte depletion filters treatment outcome meta-analysis. |
| title | Clinical prognosis of intraoperative blood salvage autotransfusion in liver transplantation for hepatocellular carcinoma: A systematic review and meta-analysis |
| title_full | Clinical prognosis of intraoperative blood salvage autotransfusion in liver transplantation for hepatocellular carcinoma: A systematic review and meta-analysis |
| title_fullStr | Clinical prognosis of intraoperative blood salvage autotransfusion in liver transplantation for hepatocellular carcinoma: A systematic review and meta-analysis |
| title_full_unstemmed | Clinical prognosis of intraoperative blood salvage autotransfusion in liver transplantation for hepatocellular carcinoma: A systematic review and meta-analysis |
| title_short | Clinical prognosis of intraoperative blood salvage autotransfusion in liver transplantation for hepatocellular carcinoma: A systematic review and meta-analysis |
| title_sort | clinical prognosis of intraoperative blood salvage autotransfusion in liver transplantation for hepatocellular carcinoma a systematic review and meta analysis |
| topic | hepatocellular carcinoma intraoperative blood salvage autotransfusion liver transplantation leukocyte depletion filters treatment outcome meta-analysis. |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.985281/full |
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