Blood transfusion for radical hysterectomy before and after the discovery of transfusion-related human immunodeficiency virus infection Journal Article


Authors: Benjamin, I.; Barakat, R. R.; Curtin, J. P.; Jones, W. B.; Lewis, J. L. Jr; Hoskins, W. J.
Article Title: Blood transfusion for radical hysterectomy before and after the discovery of transfusion-related human immunodeficiency virus infection
Abstract: Objective: To compare the patterns of perioperative blood transfusion in patients undergoing radical hysterectomy in time periods before and after the discovery of transfusion-related human immunodeficiency virus (HIV) infection. Methods: We reviewed the medical records of all patients who underwent radical hysterectomy and pelvic lymphade-nectomy at Memorial Sloan-Kettering Cancer Center during two time periods, an early period (January 1, 1980 through December 31, 1993) and a late period (July 1, 1991 through June 30, 1993). The early period preceded and the late period coincided with the era of increased awareness of transfusion-related HIV infections. Results: One hundred twenty-eight patients underwent radical hysterectomy in the early period and 71 in the late period. In the late period, markedly fewer units of blood were transfused per patient (0.62 versus 3.5). Most patients in the early period received at least one unit (117 of 128, 91%), compared with less than half (31 of 71, 44%) in the late period. For patients who received transfusions, notably fewer received homologous blood during the late (6 of 31, 19%) versus the early period (117 of 117, 100%). Using an unpaired t test and the 95% confidence interval (CI), we found that the patients in the late period had a shorter mean postoperative length of stay (11 versus 14 days, P < .0001, 95% CI ± 1.3) and were discharged with a significantly lower mean hemoglobin level (9.7 versus 11.4 g/dL, P < .0001, 95% CI ± 0.35). The mean estimated blood loss was lower in the late period (756 versus 1598 mL). We defined the transfusion index as the number of units transfused per 500 mL of estimated blood loss. The mean transfusion index was significantly lower during the late period (0.38 versus 1.1, P < .001, 95% CI ± 0.19) Conclusions: During the perioperative period for radical hysterectomy and pelvic lymphadenectomy, the incidence of blood transfusion at our institution has markedly decreased over the past decade without immediate adverse effects on postoperative recovery. The reasons for this are probably multifactorial. However, the contribution of increased concern about transfusion-related HIV infections must be considered. Preoperative autologous donation can notably decrease the need for homologous transfusion. (Obstet Gynecol 1994;84:974-8) © 1994 by The American College of Obstetricians and Gynecologists.
Keywords: adult; controlled study; aged; retrospective studies; major clinical study; comparative study; human immunodeficiency virus infection; hysterectomy; risk factor; length of stay; blood transfusion; medical practice; infection control; blood loss, surgical; virus transmission; hiv infections; middle age; human; female; priority journal; article
Journal Title: Obstetrics and Gynecology
Volume: 84
Issue: 6
ISSN: 0029-7844
Publisher: Lippincott Williams & Wilkins  
Date Published: 1994-12-01
Start Page: 974
End Page: 978
Language: English
PROVIDER: scopus
PUBMED: 7970480
DOI/URL:
Notes: Export Date: 14 January 2019 -- Article -- Source: Scopus
Citation Impact
MSK Authors
  1. William Hoskins
    254 Hoskins
  2. Richard R Barakat
    629 Barakat
  3. John P Curtin
    112 Curtin
  4. Walter   Jones
    94 Jones
  5. John   Lewis
    131 Lewis