Advantages of Intraoperative Blood Salvage with Blood Irradiation in Cancer Surgery

Abstract

The demand for intraoperative blood salvage (IBS) in cancer surgery originates from the high transfusion rate, the unfavorable effects of anemia, and the special impact of transfusion risks such as immunomodulation in tumor patients. The advantages of IBS are availability, low waste rate, and excellent quality of the autologous, unstored blood. Effective elimination of tumor cell dissemination by retransfusion of wound blood can be achieved only by blood irradiation. Combining established methods of IBS and blood irradiation is feasible and allows efficient saving of blood. For Jehovah’s witnesses it may open the option of tumor surgery. From an anesthesiological point of view IBS blood is not a drug but part of the therapy. Even if it is viewed as drug, practical medicolegal regulations are in sight. IBS with blood irradiation provides the safest and best blood for optimal hemotherapy in tumor patients. In addition, first data indicate a better outcome of patients in whom IBS was performed.

Replacement of perioperative blood loss for cancer patients

“…Hier wird berichtet, dass sich bis zu 40% der Pa tienten nicht für eine präoperative Eigen blutspende anbieten. Neben diesen Grün den wird auch die verringerte Rekonva leszenzmöglichkeit durch eine konsumie rende Erkrankung als Grund dafür ange geben, warum bei Karzinompatienten die Quote der Patienten, welche sich für eine Eigenblutspende anbietet, noch niedriger liegt [8,9].…”

Perioperative blood salvage

“…bone and liver metastasis), since one third of all banked blood is used in this field. In our and other hospitals this meanwhile amounts to half of the applications of blood salvage [2].…”

“…We have used blood salvage with blood irradiation in cancer surgery for 10 years now. Our experience shows feasibility, blood‐saving efficacy and indications for improvement of patients’ outcome [2].…”

Técnicas hemoterápicas em cirurgia renal percutânea em paciente testemunha de Jeová

“…A recuperação intra-operatória de sangue deve ser contra-indicada em cirurgias oncológicas e infectadas, uma vez que a máquina não esteriliza o sangue a ser reinfundido. A irradiação com 50 Gy na bolsa de sangue obtida da recuperação intra-operatória de sangue em cirurgias oncológicas, torna a amostra isenta de células neoplásicas e, portanto, passível de reinfusão autóloga 4,5 . Na dúvida de infecção no sangue aspirado, pode-se lançar mão do esfregaço corado pelo Gram e da hemocultura.…”