WEDNESDAY, Dec. 11, 2024 (HealthDay News) — For patients undergoing liver resection, hypovolemic phlebotomy reduces perioperative red blood cell transfusions compared with usual care, according to a study published online Dec. 9 in The Lancet Gastroenterology and Hepatology.
Guillaume Martel, MD, from the University of Ottawa in Ontario, Canada, and colleagues conducted a superiority, randomized controlled trial to investigate whether hypovolemic phlebotomy before liver resection is superior to usual care for reducing red blood cell transfusions. A total of 486 patients were randomly assigned to hypovolemic phlebotomy (removal of 7 to 10 ml/kg of whole blood without volume replacement) or usual care (245 and 241 participants, respectively); 22 and 18 patients, respectively, were excluded from the primary analysis population because they did not undergo liver resection.
The researchers found that 8 and 16 percent of patients who received hypovolemic phlebotomy and usual care, respectively, had received a perioperative red blood cell transfusion after 30 days (difference: -8.8 percentage points; adjusted risk ratio: 0.47). Overall, 17 and 16 percent of patients receiving hypovolemic phlebotomy and usual care, respectively, had major complications lasting up to 30 days; total complications up to 30 days occurred in 61 and 52 percent, respectively. No postoperative mortality was observed up to 90 days.
“The use of hypovolemic phlebotomy prior to liver transection resulted in significantly fewer perioperative red blood cell transfusions than with usual care,” the authors write.
Several authors revealed ties to the pharmaceutical industry.
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