Characteristics of Transfusion and Association With Oncologic Outcomes in Hepatoblastoma Resection

It's not uncommon for a patient with hepatoblastoma to need a transfusion during resection. But do we know if this affects oncologic outcomes? I'm Jill Kneroth with Staker and MD, and this is an article you should know. This was a multi-institutional study published in Pediatric Blood and Cancer in 2025. They looked at how intraoperative transfusion may affect recurrence and survival in these patients. So what did they find? Of those transfused, the majority of them received red blood cells, but only 11% received platelets. Intraoperative blood transfusions had no effect on recurrence, however, they were associated with increased death. Importantly, they found instances of unnecessary blood transfusions. Patients who were transfused had higher post-op hemoglobin, however, they still required more plasma and platelets postoperatively. What do the authors suggest? The authors think that blood transfusions were mostly red blood cells, and that is what contributed to the post-op coagulopathy. They recommend more careful patient selection for intraoperative transfusions and a balanced transfusion approach. Does this change the way you see intraoperative transfusions?