Advertisement

Application of Perioperative Transfusion Trigger Score in Patients Undergoing Surgical Treatment of Malignant Tumor

  • Fan ZhangEmail author
  • Ze-Bing Zheng
  • Zhao-Qiong Zhu
  • De-Xing Liu
  • Jin Liu
Original Article
  • 5 Downloads

Abstract

The present study aimed to investigate the clinical effects of the brand new perioperative transfusion trigger score (POTTS) system in patients undergoing malignant tumor surgeries. 442 cases of patients diagnosed with malignant tumor were randomly selected (from January 2012 to December 2016) from Zunyi Medical University and were divided into 3 experimental groups. Patients in the POTTS group were transfused by the POTTS guideline perioperatively, while patients in the 7–10 g group were treated by the traditional transfusion guidelines existed (restrictive transfusion strategy), patients in the 10 g group should be transfused to keep the Hb level no less than 10 g/dL (liberal transfusion strategy). Baseline information, operation time, bleeding volume, transfusion amount, incision healing time, postoperative complications, metastasis and recurrence were observed and recorded. Postoperative short-term mortality was comparable of the 3 groups, 3 cases of death all occurred in 10 g group, there was no significant difference in the incidence of postoperative complications, including infectious complications and coagulation related complications. Follow-up to date, there were 25 cases, 29 cases and 29 cases of tumor recurrence and metastasis in the three groups, but no statistical difference observed. The present findings show that the POTTS transfusion system is more advantageous with regard to save blood and relieve economic burdens of patients, and does not affect the long-term recurrence and metastasis rate of malignant tumor.

Keywords

POTTS Transfusion Malignant tumor Prognosis 

Notes

Acknowledgements

The present authors would like to acknowledge all the authors of the original studies included in the study.

References

  1. 1.
    McGrath C (2016) Blood transfusion strategies for hemostatic resuscitation in massive trauma. Nurs Clin North Am 51(1):83–93CrossRefPubMedGoogle Scholar
  2. 2.
    Deveau SR (2016) Blood products and their use in traumatic major haemorrhage. Emerg Nurse 23(9):31–37CrossRefPubMedGoogle Scholar
  3. 3.
    Carson JL (2015) The shifting paradigm for transfusion of red blood cells. Clin Adv Hematol Oncol 13(3):152–154PubMedGoogle Scholar
  4. 4.
    Klein HG, Flegel WA, Natanson C (2015) Red blood cell transfusion: precision vs imprecision medicine. JAMA 314(15):1557–1558CrossRefPubMedGoogle Scholar
  5. 5.
    Goodnough LT, Shah N (2015) Is there a "magic" hemoglobin number? Clinical decision support promoting restrictive blood transfusion practices. Am J Hematol 90(10):927–933CrossRefPubMedGoogle Scholar
  6. 6.
    American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies (2006) Practice guidelines for perioperative blood transfusion and adjuvant therapies: an updated report by the American Society of Anesthesiologists task force on perioperative blood transfusion and adjuvant therapies. Anesthesiology 105:198–208CrossRefGoogle Scholar
  7. 7.
    Murphy MF, Wallington TB, Kelsey P et al (2001) Guidelines for the clinical use of red cell transfusions. Br J Haematol 113:24–31CrossRefPubMedGoogle Scholar
  8. 8.
    Hebert PC, Wells G, Blajchman MA et al (1999) A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group. N Engl J Med 340:409–417CrossRefPubMedGoogle Scholar
  9. 9.
    Lacroix J, Hebert PC, Hutchison JS et al (2007) Transfusion strategies for patients in pediatric intensive care units. N Engl J Med 356:1609–1619CrossRefPubMedGoogle Scholar
  10. 10.
    Hajjar LA, Vincent JL, Galas FR et al (2010) Transfusion requirements after cardiac surgery: the TRACS randomized controlled trial. JAMA 304:1559–1567CrossRefPubMedGoogle Scholar
  11. 11.
    Yu X, Chen W, Liu Z et al (2016) Safety and current status of blood transfusion in China: an update. Lancent Haematol 3(2):e60–e62CrossRefGoogle Scholar
  12. 12.
    Carson JL, Carless PA, Hebert PC (2013) Outcomes using lower vs higher hemoglobin thresholds for red blood cell transfusion. JAMA 309(1):83–84CrossRefPubMedGoogle Scholar
  13. 13.
    Chang TM (2015) Red blood cell replacement, ornanobiotherapeutics with enhanced red blood cell functions? Artif Cells Nanomed Biotechnol 43(3):145–147CrossRefPubMedGoogle Scholar
  14. 14.
    Keyhanian Sh, Ebrahimifard M, Zandi M (2014) Investigation on artificial blood or substitute blood replace the natural blood. Iran J Ped Hematol Oncol 4(2):72–77PubMedGoogle Scholar
  15. 15.
    Kumar R, Sedky MJ, Varghese SJ et al (2016) Transfusion Related Acute Lung Injury (TRALI): a single institution experience of 15 years. Indian J Hematol Blood Transfus 32(3):320–327CrossRefPubMedGoogle Scholar
  16. 16.
    Takei T, Amin NA, Schmid G et al (2009) Progress in global blood safety for HIV. J Acquir Immune Defic Syndr 52:127–131CrossRefGoogle Scholar
  17. 17.
    Berra L, Pinciroli R, Stowell CP et al (2014) Autologous transfusion of stored red blood cells increases pulmonary artery pressure. Am J Respir Crit Care Med 190(7):800–807CrossRefPubMedGoogle Scholar
  18. 18.
    Rerambiah LK, Rerambiah LE, Bengone C et al (2014) The risk of transfusion-transmitted viral infections at the Gabonese National Blood Transfusion Centre. Blood Transfus 12(3):330–333PubMedGoogle Scholar
  19. 19.
    Chen A, Trivedi AN, Jiang L et al (2015) Hospital blood transfusion patterns during major noncardiac surgery and surgical mortality. Medicine (Baltimore) 94(32):e1342CrossRefGoogle Scholar
  20. 20.
    Hovaguimian F, Myles PS (2016) Restrictive versus liberal transfusion strategy in the perioperative and acute care settings: a context-specific systematic review and meta-analysis of randomized controlled trials. Anesthesiology 125(1):46–61CrossRefPubMedGoogle Scholar
  21. 21.
    Prescott LS, Taylor JS, Lopez-Olivo MA et al (2016) How low should we go: a systematic review and meta-analysis of the impact of restrictive red blood cell transfusion strategies in oncology. Cancer Treat Rev 46:1–8CrossRefPubMedGoogle Scholar
  22. 22.
    Rohde JM, Dimcheff DE, Blumberg N et al (2014) Health care-associated infection after red blood cell transfusion: a systematic review and meta-analysis. JAMA 311:1317–1326CrossRefPubMedGoogle Scholar
  23. 23.
    Gantt CL (1981) Red blood cells for cancer patients. Lancet 2(8242):363CrossRefPubMedGoogle Scholar
  24. 24.
    Claas FH, Roelen DL, van Rood JJ et al (2001) Modulation of the alloimmune response by blood transfusions. Transfus Clin Biol 8(3):315–317CrossRefPubMedGoogle Scholar
  25. 25.
    Blumberg N, Heal J, Chuang C et al (1988) Ferther evidence supporting a cause and effect relationship between blood transfusion and earlier cancer recurrence. Ann Surg 207(4):410–415CrossRefPubMedGoogle Scholar
  26. 26.
    Vidal O, Metges JP, Elizalde I et al (2009) High preoperative serum vascular endothelial growth factor levels predict poor clinical outcome after curative resection of gastric cancer. Br J Surg 96(12):1443–1451CrossRefPubMedGoogle Scholar
  27. 27.
    Kim JK, Kim HS, Park J et al (2016) Perioperative blood transfusion as a significant predictor of biochemical recurrence and survival after radical prostatectomy in patients with prostate cancer. PLoS ONE 11(5):e0154918CrossRefPubMedGoogle Scholar
  28. 28.
    Hwang HK, Jung MJ, Lee SH et al (2016) Adverse oncologic effect s of intraoperative transfusion during pancreatectomy for left-sided pancreatic cancer: the need for strict transfusion policy. J Hepatobiliary Pancreat Sci 23(8):497–501CrossRefPubMedGoogle Scholar
  29. 29.
    Mortensen Frank V (2011) Cause-specific mortality associated with leukoreduced, buffy coat-depleted, or no blood transfusion after elective surgery for colorectal cancer a postrial 15-year follow-up study. Transfusion 51(2):259–263CrossRefPubMedGoogle Scholar
  30. 30.
    Francis DM (1991) Relationship between blood and tumour behaviour. Br J Surg 78(12):1420–1428CrossRefPubMedGoogle Scholar
  31. 31.
    Vamvakas E, Moore SB (1993) Perioperative blood transfusion and colorectal cancer recurrence: a qualitative statistical overview and meta-analysis. Transfusion 33(9):754–765CrossRefPubMedGoogle Scholar
  32. 32.
    McGehee RP, Dodson MK, Moore JL et al (1994) Effect of blood transfusion in patients with gynecologic malignancy. Int J Gynaecol Obstet 46(1):45–52CrossRefPubMedGoogle Scholar
  33. 33.
    Greenawalt JA, Zernell D (2017) Autologous blood transfusion for postpartum hemorrhage. MCN Am J Matern Child Nurs 42(5):269–275CrossRefPubMedGoogle Scholar
  34. 34.
    Gonzalez DO, Cooper JN, Mantell E et al (2017) Perioperative blood transfusion and complications in children undergoing surgery for solid tumors. J Surg Res 216:129–137CrossRefPubMedGoogle Scholar
  35. 35.
    Eckel AM, Hess JR (2017) Transfusion practice in trauma resuscitation. South Med J 110(8):554–558CrossRefPubMedGoogle Scholar
  36. 36.
    Pérel Y, Runel C, Huguenin Y et al (2017) Transfusion and its specific problems in pediatrics and neonatology. Transfus Clin Biol 24(3):101–105CrossRefPubMedGoogle Scholar
  37. 37.
    Nixon CP, Tavares MF, Sweeney JD (2017) How do we reduce plasma transfusion in Rhode Island? Transfusion 57(8):1863–1873CrossRefPubMedGoogle Scholar

Copyright information

© Indian Society of Hematology and Blood Transfusion 2019

Authors and Affiliations

  1. 1.Department of AnesthesiologyThe Affiliated Hospital of Zunyi Medical UniversityZunyiPeople’s Republic of China
  2. 2.Department of Pediatric SurgeryThe Affiliated Hospital of Zunyi Medical UniversityZunyiPeople’s Republic of China
  3. 3.Department of Anesthesiology and Translational Neuroscience Center, West China HospitalSichuan UniversityChengduPeople’s Republic of China
  4. 4.Department of AnesthesiologyZunyi Medical UniversityZunyiPeople’s Republic of China

Personalised recommendations