Intraoperative Cell Salvage During Radical Cystectomy Does Not Affect Long-Term Survival

Nieder, Alan M.; Manoharan, M.; Yang, Yulong; Soloway, Mark S.

doi:10.1016/j.urology.2007.01.060

Cited by 60 publications

(69 citation statements)

References 13 publications

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“…More recently Neider and co-workers retrospectively reviewed 1038 patients undergoing radical prostatectomy between 1992 and 2003 and found no difference in biochemical recurrence on five-year follow-up between the patients receiving cell salvaged blood and those that received no blood [7]. In 2007 the same group reported on long term survival in a group of 378 patients undergoing radical prostatectomy between 1992 and 2005 and found no difference in disease-specific or overall survival between those who received cell salvaged blood and those who did not [8]. A recent prospective study of 49 patients undergoing surgery for hepatocarcinoma has also shown no difference in recurrence rate between those who did and did not receive cell salvaged blood [9].…”

Section: Discussionmentioning

confidence: 99%

“…Patients benefit by avoiding the risks of homologous (allogeneic) blood transfusion [1] and the NHS benefits from conserving the supply of blood and, potentially, reducing costs [2]. Allogeneic transfusion has been shown to be associated with both tumour recurrence [3,4] and postoperative infections [5], and these associations are not seen with autologous transfusion [6][7][8][9][10]. In the UK pre-operative autologous donation and acute normovolaemic haemodilution are not currently recommended by the National Blood Service except in exceptional circumstances [11].…”

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confidence: 99%

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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%

mentioning

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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“…There is no evidence to support the concern about the theoretical risk of cancer dissemination. [7][8][9] We have looked at the clinical and financial benefits of using ICS as a method of reducing the ABT requirements for our RRP patients. Patients in Group A received HBTs when indicated.…”

mentioning

confidence: 99%

Intraoperative red blood cell salvage and autologous transfusion during open radical retropubic prostatectomy: a cost–benefit analysis

Ubee

Kumar

Athmanathan

et al. 2011

annals

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INTRODUCTION Open radical retropubic prostatectomy (RRP) has an average blood loss of over 1,000ml. This has been reported even from high volume centres of excellence. [1][2][3][4] We have looked at the clinical and financial benefits of using intraoperative cell salvage (ICS) as a method of reducing the autologous blood transfusion requirements for our RRP patients. MATERIALS AND METHODS Group A comprised 25 consecutive patients who underwent RRP immediately prior to the acquisition of a cell saver machine. Group B consisted of the next 25 consecutive patients undergoing surgery using the Dideco Electa (Sorin Group, Italy) cell saver machine. Blood transfusion costs for both groups were calculated and compared. RESULTS The mean postoperative haemoglobin was similar in both groups (11.1gm/dl in Group A and 11.4gm/dl in Group B). All Group B patients received autologous blood (average 506ml, range: 103-1,023ml). In addition, 5 patients (20%) in Group B received a group total of 16 units (average 0.6 units) of homologous blood. For Group A the total cost of transfusing the 69 units of homologous blood was estimated as £9,315, based on a per blood unit cost of £135. This cost did not include consumables or nursing costs. CONCLUSIONS We found no evidence that autologous transfusions increased the risk of early biochemical relapse or of disease dissemination. ICS reduced our dependence on donated homologous blood.

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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%

“…Multiple surgical programs have continued to recognize both the potential benefit of autologous transfusion Cell salvage in oncologic surgery 1065 Table 3 Tumour recurrence in patients who received intraoperative autotransfusion of ICS blood during malignancy surgery-clinical studies and the potential harm of allogeneic transfusion, and they have persisted in offering ICS (± perioperative autologous donation) to their patients undergoing resection of malignancy. 66,69,70,72,74,76 This practice has afforded more than 20 years of experience from some of these teams who clearly have experienced benefit rather than detriment to their patients. The current body of in vitro evidence together with a growing clinical experience suggest that ICS should not be withheld from patients with malignancy.…”

Section: Evolution Of Practicementioning

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 Cell Salvage During Radical Cystectomy Does Not Affect Long-Term Survival

Cited by 60 publications

References 13 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

Intraoperative red blood cell salvage and autologous transfusion during open radical retropubic prostatectomy: a cost–benefit analysis

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

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