BACKGROUND: The cryopreservation of red blood cells (RBCs) has not ever been applied to the clinical services in Korea. The aim of this study was designed to supply the frozen-thawed RBCs as a routine service through estimation of efficiency and safety after freezing, thawing and washing. METHODS: Fifteen fresh packed RBCs were frozen with 40 percent(wt/vol) glycerol. After frozen storage at -70degrees for at least one month, the RBCs were thawed and washed in the COBE 2991 blood cell processor. We measured the blood cell count, RBC recovery rate, K+, LDH, specific gravity, osmolarity, and the percentage of hemolysis in the supernatant after deglycerolization. Autologous transfusions were done to the four voluntary donors with deglycerolized autologous blood for clinical assessment. RESULTS: The freeze-thaw-wash recovery rate of RBC was 76.8+/-10.0%, which is not enough to pass the AABB standard. But the recovery rate was increased up to 87.0+/-2.1% with the 4 stepwise predilution technique. The supernatant plasma specific gravity, osmolarity, and K+ were 1.006+/-0.001, 292+/-3 mOsm/KgH20, and 1.1+/-0.2mEq/L, respectively. The Hb ATP and 2,3-DPG were 3.6+/-0.8nmol/g and 13.4+/-4.5nmol/g. In simulated study, the free hemoglobin was 2.8+/-1.1mg/dL and 0.4+/-0.2% of total hemoglobin. In four autologous transfusion cases, plasma haptoglobin level was 96.0+/-40.8 mg/dL (reference range 30~200 mg/dL) and urine hemoglobin was not observed after 2~6 hours later after transfusion. CONCLUSION: The results of this study indicated that technical experiences for freezing, thawing and washing were established for clinical use of frozen RBCs in Korea.
2,3-Diphosphoglycerate ; Adenosine Triphosphate ; Blood Cell Count ; Blood Cells* ; Cryopreservation ; Erythrocytes* ; Freezing ; Glycerol ; Haptoglobins ; Hemolysis ; Humans ; Korea ; Osmolar Concentration ; Plasma ; Specific Gravity ; Tissue Donors

Purpose: Little is known about liver resection (LR) in hepatocellular carcinoma (HCC) patients older than 75 years of age. This study aimed to compare the postoperative and long-term outcomes of hepatectomy in this patient population according to operation period. Methods: This study included 130 elderly patients who underwent LR for solitary treatment-naïve HCC between November 1998 and March 2020. Group 1 included patients who underwent LR before 2016 (n = 68) and group 2 included those who underwent LR during or after 2016 (n = 62). Results: The proportion of major LR, anatomical LR, and laparoscopic LR (LLR) in group 1 was significantly lower than those in group 2. Also, the median operation time, amount of blood loss, hospitalization length, rates of intraoperative blood transfusion, and complications in group 2 were less than those in group 1. In the subgroup analysis of group 1, high proteins induced by vitamin K absence or antagonist-II, long hospitalization, and LLR were closely associated with mortality. In the subgroup analysis of group 2, however, none of the factors increased mortality. Nevertheless, the presence of tumor grade 3 or 4 and the incidence of microvascular invasion were higher in group 1 than in group 2, and the disease-free survival and overall survival were better in group 2 than in group 1 because of minimized blood loss and quicker recovery period by increased surgical techniques and anatomical approach, and LLR. Conclusion LR in elderly HCC patients has been frequently performed recently, and the outcomes have improved significantly compared to the past.

Purpose: Hepatocellular carcinoma (HCC) is rare in HCV patients without cirrhosis, and little is known about the postoperative results of these patients. The present study compares the outcomes of cirrhotic and non-cirrhotic groups after liver resection (LR) in solitary HCV-related HCC patients and identifies risk factors for prognosis according to the presence or absence of cirrhosis in these patients. Methods: Two hundred and 7 adult hepatectomy patients with treatment-naïve solitary HCV-related HCC were identified prospectively at our institution between July 2005 and May 2019. Results: The non-cirrhotic group had better liver function than the cirrhotic group based on platelet count, liver function tests, liver stiffness measurement, and indocyanine green retention rate at 15 minutes but were older than the cirrhotic group. Consistently, noninvasive markers in the cirrhotic group were significantly higher than in the non-cirrhotic group. The cumulative disease-free survival and overall survival in the non-cirrhotic group were significantly higher than in the cirrhotic group. HCC recurrence was related to major LR and α-FP of >40 ng/mL and death was related to long hospitalization and α-FP of >40 ng/mL in multivariate analysis. Noninvasive markers and the presence of cirrhosis were not related to HCC recurrence or death in multivariate analyses. Conclusion The cirrhotic group showed poor prognosis due to poor liver function after LR compared to the non-cirrhotic group, but this was not sustained in multivariate analysis. The factors influencing HCC recurrence and death were different in the cirrhotic and non-cirrhotic groups.