Is cell salvage safe in liver resection? A pilot study

Schmidt, Annette; Sues, Harald C.; Siegel, Ekkehard; Peetz, D.; Bengtsson, Anders; Gervais, H.

doi:10.1016/j.jclinane.2009.01.012

Cited by 7 publications

(6 citation statements)

References 28 publications

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“…15 Recent outcome-driven literature has shown at minimum comparable rates of cancer recurrence when ICS is used. [18][19][20][21] This evidence is also supported by cytopathological studies that have failed to detect malignant cells in blood that was collected and filtered using modern filtration techniques. 16 Complications of allogeneic blood transfusion are well established and include transfusion reactions, transmission of infectious diseases and increased rates of post-operative infections.…”

Section: Discussionmentioning

confidence: 65%

“…16 A recent meta-analysis has shown the receipt of autotransfused blood from ICS has not been associated with higher rates of cancer recurrence, dispelling historical concerns. [18][19][20][21] Use of ICS has been shown to reduce the need for allogeneic blood transfusions in surgical procedures by 38% (RR 0.62; 95% CI 0.55-0.70). 17 While ICS may offer the opportunity to reduce costs associated with intra-operative allogeneic blood transfusion, use of the device is accompanied by notable direct medical costs.…”

Section: Introductionmentioning

confidence: 99%

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A decision model and cost analysis of intra-operative cell salvage during hepatic resection

Lemke

Eeson

Lin

et al. 2016

HPB

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Section: Discussionmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

A decision model and cost analysis of intra-operative cell salvage during hepatic resection

Lemke

Eeson

Lin

et al. 2016

HPB

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“…13,16,17 Our review and other publications have not found any significant difference in cancer-related outcomes between patients who did and did not receive IBSA in oncologic liver surgery. [73][74][75] However, majority of the existing literature and oncologic studies included within our review examines HCC. Data are limited on the oncologic safety of IBSA use in liver surgery for malignancies beyond HCC, such as colorectal liver metastasis or cholangiocarcinoma, which may have significantly greater circulating tumor burden compared with early-stage HCC.…”

Section: Discussionmentioning

confidence: 99%

Should Cell Salvage Be Used in Liver Resection and Transplantation? A Systematic Review and Meta-analysis

et al. 2022

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Objective: To evaluate the effect of intraoperative blood cell salvage and autotransfusion (IBSA) use on red blood cell (RBC) transfusion and postoperative outcomes in liver surgery. Background: Intraoperative RBC transfusions are common in liver surgery and associated with increased morbidity. IBSA can be utilized to minimize allogeneic transfusion. A theoretical risk of cancer dissemination has limited IBSA adoption in oncologic surgery. Methods: Electronic databases were searched from inception until May 2021. All studies comparing IBSA use with control in liver surgery were included. Screening, data extraction, and risk of bias assessment were conducted independently, in duplicate. The primary outcome was intraoperative allogeneic RBC transfusion (proportion of patients and volume of blood transfused). Core secondary outcomes included: overall survival and disease-free survival, transfusion-related complications, length of hospital stay, and hospitalization costs. Data from transplant and resection studies were analyzed separately. Random effects models were used for meta-analysis. Results: Twenty-one observational studies were included (16 transplant, 5 resection, n=3433 patients). Seventeen studies incorporated oncologic indications. In transplant, IBSA was associated with decreased allogeneic RBC transfusion [mean difference –1.81, 95% confidence interval (−3.22, −0.40), P=0.01, I2=86%, very-low certainty]. Few resection studies reported on transfusion for meta-analysis. No significant difference existed in overall survival or disease-free survival in liver transplant [hazard ratio (HR)=1.12 (0.75, 1.68), P=0.59, I2=0%; HR=0.93 (0.57, 1.48), P=0.75, I2=0%] and liver resection [HR=0.69 (0.45, 1.05), P=0.08, I2=0%; HR=0.93 (0.59, 1.45), P=0.74, I2=0%]. Conclusion: IBSA may reduce intraoperative allogeneic RBC transfusion without compromising oncologic outcomes. The current evidence base is limited in size and quality, and high-quality randomized controlled trials are needed.

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“…However, considering that the unconfi rmed risk of spreading tumor cell is not a problem in the case of benign liver tumors, the use of cell saver should always be considered [ 15 ]. Furthermore, Schmidt A. et al have demonstrated that cell-salvaged blood in liver resection seems to be safe for retransfusion with respect to cytokine release and complement activation [ 16 ].…”

Section: Intraoperative Managementmentioning

confidence: 99%

Blood and Transfusion Management in Liver Surgery

Pulitanò

2015

Benign Tumors of the Liver

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Is cell salvage safe in liver resection? A pilot study

Cited by 7 publications

References 28 publications

A decision model and cost analysis of intra-operative cell salvage during hepatic resection

A decision model and cost analysis of intra-operative cell salvage during hepatic resection

Should Cell Salvage Be Used in Liver Resection and Transplantation? A Systematic Review and Meta-analysis

Blood and Transfusion Management in Liver Surgery

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