Intraoperative Autotransfusion in Hepatic Resection for Malignancy

Zulim, Rebecca A.; Rocco, Monica; Goodnight, James E.; Smith, G. Jeffrey; Krag, David N.; Schneider, Philip D.

doi:10.1001/archsurg.1993.01420140083013

Cited by 53 publications

(41 citation statements)

References 21 publications

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“…All the in-vivo evidence has shown that cancer patients receiving cell salvaged blood do not get increased rates of recurrences or increased mortality, and there has been considerable clinical use of cell salvage in all types of cancer surgeryparticularly urology, over the last 20 years. Up to 2003 the evidence consisted of a small number of case reports and observational studies [51][52][53][54][55][56][57][58][59], and has been criticised as a result [50]. However, they do show no difference in recurrence rate with intra-operative cell salvage or a better outcome compared with allogeneic transfusion.…”

Section: Discussionmentioning

confidence: 99%

Use of a leucocyte filter to remove tumour cells from intra‐operative cell salvage blood

Catling¹,

Williams²,

Freites³

et al. 2008

Anaesthesia

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SummaryThe intra-operative blood loss of 50 consecutive gynae-oncology patients undergoing surgery for endometrial, cervical or ovarian cancer was cell salvaged and filtered. In each case blood samples were taken from the effluent tumour vein, a central venous line, the cell saver reservoir, the cell salvage re-transfusion bag after processing but before filtration and from the cell salvage re-transfusion bag after processing and filtration. Samples were examined using immunohistochemical monoclonal antibody markers for epithelial cell lines. Viable, nucleated malignant cells were detected in 2 ⁄ 50 central venous samples, 34 ⁄ 50 reservoir samples and 31 ⁄ 50 unfiltered cell salvaged samples. After passage through a Pall RS leucocyte depletion filter no remaining viable, nucleated malignant cells were detected in any sample. The clinical risks of cell salvage in these circumstances should be reviewed in the light of the risks of allogeneic blood transfusion.

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Section: Discussionmentioning

confidence: 99%

Use of a leucocyte filter to remove tumour cells from intra‐operative cell salvage blood

Catling¹,

Williams²,

Freites³

et al. 2008

Anaesthesia

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“…Fresh frozen plasma was used in patients with Child-Pugh grade B disease. None of the patients received intraoperative haemodilution 11 , intraoperative blood salvage 12 or autologous blood transfusion 13 -15 .…”

Section: Methodsmentioning

confidence: 99%

Autologous blood storage before hepatectomy for hepatocellular carcinoma with underlying liver disease

Itamoto

Katayama

Nakahara

et al. 2003

British Journal of Surgery

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Background: Preoperative autologous blood donation has been suggested for patients with liver disease who are to undergo liver resection. The aim of this retrospective study was to clarify the risk factors for increased blood loss and the need for blood transfusion during hepatectomy for hepatocellular carcinoma (HCC).Methods: From January 1996 to December 2000, 206 consecutive patients, 98·5 per cent of whom had underlying liver disease, underwent elective hepatectomy for HCC.Results: Major hepatectomy was performed in 34 patients (16·5 per cent) and minor hepatectomy in 172 patients (83·5 per cent). The mean blood loss was 410 (median 260) ml. Eleven (5·3 per cent) of the 206 patients received blood transfusion during or after the operation. Operation time (P = 0·004) and central venous pressure (CVP) (P = 0·041) were independently correlated with blood loss of more than 1000 ml. Only preoperative haemoglobin level (P = 0·001) was independently correlated with the need for blood transfusion. Conclusion:In patients with underlying liver disease, maintaining CVP at a level below 5 cmH 2 O during parenchymal transection to reduce blood loss is more important than reserving autologous blood before the operation.

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“…64 Malignancy recurrence or metastases secondary to perioperative transfusion practices is a difficult field of study given the heterogeneity of the clinical circumstance, the type and stage of cancer, and the long follow-up times required. Nonetheless, 15 clinical studies have been published reporting outcomes on patients who received transfusion of ICS blood intraoperatively during malignancy surgery [64][65][66][67][68][69][70][71][72][73][74][75][76][77][78] (Table 3). The majority of these studies were single-centre non-randomized small studies where the outcome of patients who received intraoperative ICS blood was compared with historic or case controls.…”

Section: Clinical Experiencementioning

confidence: 99%

Should intraoperative cell-salvaged blood be used in patients with suspected or known malignancy?

Trudeau

Waters

Chipperfield

2012

Can J Anesth/J Can Anesth

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Should intraoperative cell-salvaged blood be used in patients with suspected or known malignancy? Les cellules sanguines épargnées en peropératoire doivent-elles être réutilisées chez des patients ayant des processus malins connus ou suspectés? Abstract Purpose Intraoperative cell salvage (ICS) is used as an alternative to allogeneic blood transfusion in an attempt to avoid or minimize the risks associated with allogeneic blood. Intraoperative cell salvage is generally avoided in surgeries where malignancy is confirmed or suspected due to concern for potential metastasis or cancer recurrence. The application of post-processing methods for ICS is hypothesized to eliminate this potential risk. The purpose of this narrative review is to examine the in vitro experimental evidence as it pertains to the removal of tumour cells from ICS blood and to review the clinical studies where ICS blood has been used in patients with malignancy. Source A search of the English literature for relevant articles published from 1973 to 2012 was undertaken using

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Intraoperative Autotransfusion in Hepatic Resection for Malignancy

Cited by 53 publications

References 21 publications

Use of a leucocyte filter to remove tumour cells from intra‐operative cell salvage blood

Use of a leucocyte filter to remove tumour cells from intra‐operative cell salvage blood

Autologous blood storage before hepatectomy for hepatocellular carcinoma with underlying liver disease

Should intraoperative cell-salvaged blood be used in patients with suspected or known malignancy?

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