Hemodynamics, fluids & transfusion
Hepatocellular Cancer Recurrence After Liver Transplantation With and Without the Use of Intraoperative Blood Salvage and Autotransfusion: A Retrospective Study
Authors' conclusion
In this single-center study, IBS and autotransfusion during LT in patients with concurrent HCC was not associated with an increased risk of recurrence.
Study context
- Population
- Adults with hepatocellular carcinoma (HCC) undergoing deceased donor liver transplantation (LT) at a single Australian LT centre (August 2007-July 2020)analysed
- Participants
- 245 adults
- Exposure
- Intraoperative blood salvage (IBS) and autotransfusion vs no IBS during LT
- IBSn = 167
- No IBSn = 78reference
- Outcome
- Time to HCC recurrence
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
IBS vs No IBSEstimate (95% CI)P value
Unadjusted
HR 0.80(0.34–1.92)
P = 0.62Adjusted for hepatitis C, number of HCCs, alpha-fetal protein, microvascular invasion
aHR 0.57(0.23–1.44)
P = 0.24Observational data: associations, not effects.
Secondary outcomes
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| HCC recurrence-free survivalMultivariable analysis | 0.75 (0.39–1.42) | P = 0.38 | |
| Overall survivalMultivariable analysis | 0.68 (0.35–1.33) | P = 0.26 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
HCC recurrence, overall cohort
- HCC recurrence
- 22/245 (9.0%)
- Median time to recurrence, months (IQR 13.5-24.5)
- 20
Independent predictors of time to HCC recurrence
- Hepatitis C, aHR
- 3.57 (95% CI 1.03-12.4, P = .04)
- Number of HCCs, aHR per lesion increase
- 1.17 (95% CI 1.06-1.30, P < .01)
- Higher alpha-fetal protein, aHR per kIU/L increase
- 1.002 (95% CI 1.0003-1.003, P = .01)
- Microvascular invasion, aHR
- 3.27 (95% CI 1.26-8.50, P = .01)
Original publication
Hepatocellular Cancer Recurrence After Liver Transplantation With and Without the Use of Intraoperative Blood Salvage and Autotransfusion: A Retrospective Study. Anesth Analg. Published 20 March 2026. doi:10.
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