Ist die Elimination von Osteosarkomzellen durch ?maschinelle Autotransfusion? und LeukozytenDepletionsfilter m�glich?

Müller, Markus; Kühn, D.; Hinrichs, Bernd; Schindler, Ehrenfried; Dreyer, Thomas; Hirsch, C.; Schäffer, Rafael; Hempelmann, G.

doi:10.1007/s001010050318

Cited by 14 publications

(7 citation statements)

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“…The filtration efficacy in terms of cancer cell reduction using a newer generation of LDFs is 99.6% [60] to 99.9% [61]. This was demonstrated for a large variety of tissues such as prostate and renal cancer [62]; osteosarcoma [63]; breast [64]; colorectal [65]; pancreatic [23]; hepatocellular [66]; endometrium, cervical, and ovarian [67]; spinal metastases [68]; and lung cancer [69].…”

Section: Discussionmentioning

confidence: 99%

Safety of Intraoperative Cell Salvage in Cancer Surgery: An Updated Meta-Analysis of the Current Literature

Frietsch¹,

Steinbicker

Horn

et al. 2022

Transfus Med Hemother

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Background: Allogeneic blood transfusions in oncologic surgery are associated with increased recurrence and mortality. Adverse effects on outcome could be reduced or avoided by using intraoperative autologous blood cell salvage (IOCS). However, there are concerns regarding the safety of the autologous IOCS blood. Previous meta-analyses from 2012 and 2020 did not identify increased risk of cancer recurrence after using autologous IOCS blood. The objective of this review was to reassess a greater number of IOCS-treated patients to present an updated and more robust analysis of the current literature. Methods: This systematic review includes full-text articles listed in PubMed, Cochrane, Cochrane Reviews, and Web of Science. We analyzed publications that discussed cell salvage or autotransfusion combined with the following outcomes: cancer recurrence, mortality, survival, allogeneic transfusion rate and requirements, length of hospital stay (LOS). To rate the strength of evidence, a Grading of Recommendations Assessment, Development and Evaluation (GRADE) of the underlying evidence was applied. Results: In the updated meta-analysis, 7 further observational studies were added to the original 27 observational studies included in the former 2020 analysis. Studies compared either unfiltered (n = 2,311) or filtered (n = 850) IOCS (total n = 3,161) versus non-IOCS use (n = 5,342). Control patients were either treated with autologous predonated blood (n = 484), with allogeneic transfusion (n = 4,113), or did not receive a blood transfusion (n = 745). However, the current literature still contains only observational studies on these topics, and the strength of evidence remains low. The risk of cancer recurrence was reduced in recipients of autologous salvaged blood with or without LDF (odds ratio [OR] 0.76, 95% confidence interval [CI]: 0.64–0.90) compared to nontransfused patients or patients with allogeneic transfusion. There was no difference in mortality (OR 0.95, 95% CI: 0.71–1.27) and LOS (mean difference −0.07 days, 95% CI: −0.63 to 0.48) between patients treated with IOCS blood or those in whom IOCS was not used. Due to high heterogeneity, transfusion rates or volumes could not be analyzed. Conclusion: Randomized controlled trials comparing mortality and cancer recurrence rate of IOCS with or without LDF filtration versus allogeneic blood transfusion were not found. Outcome was similar or better in patients receiving IOCS during cancer surgery compared to patients with allogeneic blood transfusion or nontransfused patients.

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Section: Discussionmentioning

confidence: 99%

Safety of Intraoperative Cell Salvage in Cancer Surgery: An Updated Meta-Analysis of the Current Literature

Frietsch¹,

Steinbicker

Horn

et al. 2022

Transfus Med Hemother

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“…(1994 ), using a Dideco Autotrans BT 725, Sepacell R‐500 filters and COLO 38 cells, estimated that 92.5% of the cells were removed in the washing stage and then showed that the remaining 7.5% were removed by filtration. Müller et al . (1996 ), using osteosarcoma cells and Pall BF4 filters, showed similar results.…”

Section: Fields Containing Malignant Tissuementioning

confidence: 99%

Infected and malignant fields are an absolute contraindication to intraoperative cell salvage: fact or fiction?

Mj¹

1999

Transfusion Medicine

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“…However, clinical evaluations have not found adverse effects of IAT on tumor recurrence or survival 34,41,42 , but no large outcome trials have been completed. The insertion of different leukocyte-depleting filters into the IAT processing loop has been advocated repeatedly to reduce the probability of spreading tumor cells, but results are controversial 34,[43][44][45][46][47][48] . More recently, the irradiation of the erythrocyte suspension retransfusate with 50 Gy has shown promising results 47,48 .…”

Section: Contraindicationsmentioning

confidence: 99%

Intraoperative Autotransfusion of RBC and PRP

Gombotz

Kulier

1999

Transfus Alt Transfus Med

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IntraoperativeAutotransfusion of RBC and PRP TATM 1999;3:5-13 • Intraoperative autotransfusion In addition, IP may be used when other autologous whole blood harvesting techniques are not an option. DEPARTMENT OF ANESTHESIOLOGY AND INTENSIVE CARE UNIVERSITY OF GRAZ GRAZ, AUSTRIATransfusion Alternatives in Transfusion Medicine VOLUME 1 NUMBER 3 DECEMBER 1999 Background summaryIntraoperative autotransfusion (IAT) is defined as the reinfusion of patient blood salvaged during and after surgery. IAT plays an important role in the context of perioperative blood saving strategies, having gained standard-of-care status in many surgical procedures 1,6 .The principle of IAT is to collect intraor postoperatively shed blood continuously from the operative field. The salvaged blood is aspirated from the wound site and collected in a dedicated reservoir. Under standard conditions, red cells are subsequently separated, washed, concentrated and stored for later retransfusion to the patient. Only erythrocytes are saved and retransfused; simultaneous volume and plasma replacement has to be provided, especially after processing of large quantities of shed blood 4 .In contrast to stored RBCs, freshly salvaged autologous red cells show uncompromized functional capacity, oxygen delivery to tissues and survival, indicating that IAT has no significant detrimental effects on erythrocytes 7,8 . IAT is most effective when combined with other autologous methods, particularly with preoperative autologous blood donation, acute normovolemic hemodilution or adjuvant drug therapies 4, 9, 10 . Methods Cell separation (washed blood)This technique is based on centrifugation, separating red blood cells (RBCs) from the lighter components and fluids, including plasma, saline and the buffy coat (Cell Saver, Haemolite ® , Haemonetics TM , Braintree, MA; Figure 1). Before starting the procedure, the operator must fill the system with 100-200 mL heparinized saline ("priming"), in order to prevent cells from binding to membrane surfaces initiating microaggregation, and to diminish frictional forces and damage to the cellu- Figure 1lar components 4,8 . Blood released at the wound site is aspirated via a double-lumen suction catheter (80-100 mm Hg), immediately anticoagulated (30,000 IU heparin in 1000 mL saline) at the suction tip, and stored in a plastic cardiotomy reservoir, equipped with a 120 µm microaggregate filter. When a minimum of 1000 mL shed blood is collected, it is pumped into a rotating separation chamber (Latham bowl, 225 mL adaptable capacity), washed with 1000-1500 mL saline and concentrated. Whenever the extent or kind of surgical debris requires more extensive washing, processing cycles can be selected manually, and in emergency cases, washing can be skipped entirely. For pediatric patients, smaller centrifuges are available. As soon as the preset hematocrit is reached, the spinning separator chamber stops, and packed RBCs, suspended in saline solution, are pumped into an infusion bag, while the waste products are removed 4, 11 . Afte...

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Ist die Elimination von Osteosarkomzellen durch ?maschinelle Autotransfusion? und LeukozytenDepletionsfilter m�glich?

Cited by 14 publications

References 0 publications

Safety of Intraoperative Cell Salvage in Cancer Surgery: An Updated Meta-Analysis of the Current Literature

Safety of Intraoperative Cell Salvage in Cancer Surgery: An Updated Meta-Analysis of the Current Literature

Infected and malignant fields are an absolute contraindication to intraoperative cell salvage: fact or fiction?

Intraoperative Autotransfusion of RBC and PRP

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