Investigating the association between perioperative blood transfusions and outcomes in children undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

Background and Objectives: Studies indicate the perioperative transfusion of red blood cells during oncologic surgery may be associated with worse outcomes. In this study, we evaluated the impact of red blood cell transfusions on the short- and long-term outcomes of children undergoing a major oncologic surgery. Materials and Methods: A retrospective review of the medical records of children ≤18 years of age who had undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy was performed. Univariate and multivariate analyses were performed to identify factors influencing survival, complications and length of stay. Results: Seventy-five children were identified, 80% of whom had received a red blood cell transfusion. Children who received a red blood cell transfusion had a significantly longer length of stay (P = 0·0003). However, the association between red blood cell transfusions and recurrence-free survival (HR: 1·307, 95% CI: 0·547–3·124; P = 0·55), overall survival (HR: 1·487, 95% CI: 0·585–3·780; P = 0·40) or the incidence of major complications (27·8 vs. 0% in non-transfused children, P = 0·18) was not statistically significant. Conclusion: This retrospective study of children undergoing major oncologic surgery did not demonstrate a significant association between red blood cell transfusions and worse outcomes.