Perioperative blood transfusion in hepatocellular carcinomas: influence of immunologic profile and recurrence free survival

BACKGROUND: The postoperative recurrence of hepatocellular carcinomas (HCC) associated with perioperative blood transfusion has been the subject of controversy. The authors prospectively investigated the relation between perioperative allogeneic blood transfusions, the recurrence free survival, and the immunologic profiles of patients with HCC who had undergone curative hepatic resections. METHODS: One hundred eight patients were divided into two groups: a transfused group (n = 53) and a nontransfused group (n = 55), according to their perioperative transfusion history. The subsets of lymphoid cells, natural killer cell activity and the phytohemagglutinin (PHA) response were all measured preoperatively, and at 1, 2, and 4 weeks and at 3 and 6 months after the hepatectomy. The recurrence free survival rate then was compared between these two groups. RESULTS: There were no significant differences between these two groups with respect to histologic findings, clinical stage, type of resection, pathologic data, and the recurrence free survival rate. Postoperative levels of the CD8 in the transfused group were elevated as compared with the nontransfused group, and the PHA response of the transfused patients was significantly increased at 7 postoperative days. Natural killer cell activity of the transfused patients was decreased at 7 postoperative days, as compared with the nontransfused patients, but there was no significant difference. CONCLUSIONS: Although allogeneic blood transfusion may have immunosuppressive effects, perioperative blood transfusions did not influence the cancer free survival rate in patients with hepatocellular carcinoma.