Intraoperative Transfusion of Fresh Frozen Plasma Predicts Morbidity Following Partial Liver Resection for Hepatocellular Carcinoma

Background The reduction of perioperative morbidity is a main surgical goal in patients undergoing partial hepatectomy for hepatocellular carcinoma (HCC). Here, we investigated clinical determinants of perioperative morbidity in a European cohort of patients undergoing surgical resection for HCC. Methods A total 136 patients who underwent partial hepatectomy for HCC between 2011 and 2017 at our institution were included in this analysis. The associations between major surgical complications (Clavien-Dindo >= 3) and overall morbidity (Clavien-Dindo >= 1) with clinical variables were assessed using univariate and multivariable binary logistic regression analysis. Results Multivariable analysis identified the Child-Pugh-Score (CPS, HR = 3.23; p = 0.040), operative time (HR = 5.63; p = 0.003), and intraoperatively administered fresh frozen plasma (FFP, HR = 5.62; p = 0.001) as independent prognostic markers of major surgical complications, while only FFP (HR = 6.52; p = 0.001) was associated with morbidity in the multivariable analysis. The transfusion of FFP was not associated with perioperative liver functions tests. Conclusions The intraoperative administration of FFP is an important independent predictor of perioperative morbidity in patients undergoing partial hepatectomy for HCC.

Automated summary

In a European cohort of patients undergoing surgical resection for HCC, Child-Pugh Score, operative time, and intraoperatively administered fresh frozen plasma were identified as independent prognostic markers of major surgical complications. Intraoperative administration of FFP was found to be an important independent predictor of perioperative morbidity in these patients.