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.
Similar content being viewed by others
References
McGrath C (2016) Blood transfusion strategies for hemostatic resuscitation in massive trauma. Nurs Clin North Am 51(1):83–93
Deveau SR (2016) Blood products and their use in traumatic major haemorrhage. Emerg Nurse 23(9):31–37
Carson JL (2015) The shifting paradigm for transfusion of red blood cells. Clin Adv Hematol Oncol 13(3):152–154
Klein HG, Flegel WA, Natanson C (2015) Red blood cell transfusion: precision vs imprecision medicine. JAMA 314(15):1557–1558
Goodnough LT, Shah N (2015) Is there a "magic" hemoglobin number? Clinical decision support promoting restrictive blood transfusion practices. Am J Hematol 90(10):927–933
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 105:198–208
Murphy MF, Wallington TB, Kelsey P et al (2001) Guidelines for the clinical use of red cell transfusions. Br J Haematol 113:24–31
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 340:409–417
Lacroix J, Hebert PC, Hutchison JS et al (2007) Transfusion strategies for patients in pediatric intensive care units. N Engl J Med 356:1609–1619
Hajjar LA, Vincent JL, Galas FR et al (2010) Transfusion requirements after cardiac surgery: the TRACS randomized controlled trial. JAMA 304:1559–1567
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–e62
Carson JL, Carless PA, Hebert PC (2013) Outcomes using lower vs higher hemoglobin thresholds for red blood cell transfusion. JAMA 309(1):83–84
Chang TM (2015) Red blood cell replacement, ornanobiotherapeutics with enhanced red blood cell functions? Artif Cells Nanomed Biotechnol 43(3):145–147
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):72–77
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):320–327
Takei T, Amin NA, Schmid G et al (2009) Progress in global blood safety for HIV. J Acquir Immune Defic Syndr 52:127–131
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):800–807
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):330–333
Chen A, Trivedi AN, Jiang L et al (2015) Hospital blood transfusion patterns during major noncardiac surgery and surgical mortality. Medicine (Baltimore) 94(32):e1342
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):46–61
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 46:1–8
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 311:1317–1326
Gantt CL (1981) Red blood cells for cancer patients. Lancet 2(8242):363
Claas FH, Roelen DL, van Rood JJ et al (2001) Modulation of the alloimmune response by blood transfusions. Transfus Clin Biol 8(3):315–317
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):410–415
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):1443–1451
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):e0154918
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):497–501
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):259–263
Francis DM (1991) Relationship between blood and tumour behaviour. Br J Surg 78(12):1420–1428
Vamvakas E, Moore SB (1993) Perioperative blood transfusion and colorectal cancer recurrence: a qualitative statistical overview and meta-analysis. Transfusion 33(9):754–765
McGehee RP, Dodson MK, Moore JL et al (1994) Effect of blood transfusion in patients with gynecologic malignancy. Int J Gynaecol Obstet 46(1):45–52
Greenawalt JA, Zernell D (2017) Autologous blood transfusion for postpartum hemorrhage. MCN Am J Matern Child Nurs 42(5):269–275
Gonzalez DO, Cooper JN, Mantell E et al (2017) Perioperative blood transfusion and complications in children undergoing surgery for solid tumors. J Surg Res 216:129–137
Eckel AM, Hess JR (2017) Transfusion practice in trauma resuscitation. South Med J 110(8):554–558
Pérel Y, Runel C, Huguenin Y et al (2017) Transfusion and its specific problems in pediatrics and neonatology. Transfus Clin Biol 24(3):101–105
Nixon CP, Tavares MF, Sweeney JD (2017) How do we reduce plasma transfusion in Rhode Island? Transfusion 57(8):1863–1873
Acknowledgements
The present authors would like to acknowledge all the authors of the original studies included in the study.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Zhang, F., Zheng, ZB., Zhu, ZQ. et al. Application of Perioperative Transfusion Trigger Score in Patients Undergoing Surgical Treatment of Malignant Tumor. Indian J Hematol Blood Transfus 36, 156–163 (2020). https://doi.org/10.1007/s12288-019-01180-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12288-019-01180-z