The use of blood salvage in cardiac surgery with cardiopulmonary bypass

This study demonstrated that the use of RS is not cost-effective, that there was a reduction in the number of UCH in the group that used RS and that there was no morbidity related to the application of this protocol.

Transfusion of cell saver salvaged blood in neonates and infants undergoing open heart surgery significantly reduces RBC and coagulant product transfusions and donor exposures: results of a prospective, randomized, clinical trial.

Blood collected by Cell Saver can be safely stored close to the bed with multiple fractions for 24 hr after collection, this strategy is highly desirable and makes it possible for RBCs to be available without increased exposure to a donor to correct anemia and volume replacement in a critically ill population. The rate of infections and inflammation were not increased in subjects who received Call Saver blood. The use of Autotransfusion reduced the number of blood cell transfusions in the immediate postoperative period, in addition, patients who received blood from the Cell Saver needed less exposure to coagulants and third-party transfusions, there is a trend in the reduction of infused volumes of crystalloids in the postoperative period, reduction of thrombosis and shorter duration of mechanical ventilation and inotropes, larger studies are needed to determine whether the volume of blood transfusion products are associated with improvement in the clinical picture. The use of Cell Saver Autotransfusion is cost-effective and should be considered for pediatric surgeries with CPB

Cell salvage as part of a blood conservation strategy in anesthesia (All surgeries; including surgeries (oncology).

Cell salvage and Autotransfusion are safe and effective in reducing allogeneic blood transfusion requirements, as well as being cost-effective in cardiac and orthopedic surgery. Cell salvage should be considered in all cases where significant blood loss is expected or possible, in patients with preoperative anemia and who refuse blood products. The standby system allows the rescue cell to be used in cases where the predicted blood loss is 1,000 ml but there is a possibility of significant bleeding. This will result in a greater reduction in allogeneic blood transfusion. Recent evidence has shown that cell rescue can be used in obstetrics or malignant cancer. LDFs can provide an element of security, and should be used unless retransfusion is required. In addition, enteric contamination or systemic sepsis does not preclude the use of cell salvage if proper precautions are taken. Therefore, the only absolute contraindication to the use of salvage cells should be patient refusal.

Use of a leucocyte filter to remove tumour cells from intra-operative cell salvage blood. (oncologia)

Malignant cells of epithelial origin were clearly identifiable in two of 50 blood samples from the central circulation vein, in 34 of 50 samples from the salvage of reserved cells before processing, and in 31 of 50 samples from the blood processed before using a filter. of leukocyte depletion (see Table 1). In no case were viable, detectable nucleated malignant cells in the final filtered sample of cells from the Cell Saver. Fragmented cytoplasmic debris from labeled cells was detectable in several samples in the reservoir and pre-filter and in one of the post-filter samples, indicating destruction of the labeled cells during the cell recovery process. These fragments cannot cause the tumor to spread, as they do not have a nucleus and cannot divide.

Modified Leukocyte Filter Removes Tumor Cells from the Salvaged Blood (oncologia)

For the first time, we have demonstrated that M-LDF is very effective in removing cells. removed 4

log of nucleated cells and more malignant cells (protocol 1), with 96% red cell recovery. In addition, nucleated cells were destroyed as they passed through M-LDF. Viable non-proliferative or epithelial cells were found after M-LDF filtration. Therefore, M-LDF may have potential for use during onco-surgery. As reported, cancer cells...

Our results show that M-LDF is effective in eliminating malignant cells (5 log) even with cell overload (108/L). We did not find viable malignant cells by flow cytometry, immunofluorescence, or in vitro and in vivo cell culture after M-LDF filtration as reported [11, 14, 15, 16]. The cells can be destroyed or lose their adhesive characteristics, which is critical for the formation of metastases, as it is passed through the filter. In conclusion, our results demonstrate that M-LDF can effectively remove a variety of cells. Since no viable malignant cells were found in the blood recovered after M-LDF filtration, IBS has significant potential for clinical application in oncology surgery.

Association of Anaesthetists guidelines: cell salvage for peri-operative blood conservation 2018 (oncologia)

Despite theoretical concern, there is no absolute contraindication for Cell Saver in cancer surgery. Its use is controversial because malignant cells are often present in the operative field, and can be found in recovered blood and, theoretically, metastasized after reinfusion. Circulating malignant cells are frequently present in cancer patients undergoing surgery, regardless of CS use, and very few of these cells are considered capable of causing metastasis [52]. The number of malignant cells in recovered blood can be reduced by the use of LDFs, with no apparent adverse effect on product quality [52]. The use of LDFs has not been shown to be associated with any generation of bradykinin or leukotriene in recovered blood cells [53]. Cell recovery can reduce or eliminate exposure to allogeneic blood, which has been associated with immunosuppression and cancer recurrence [54]. A major disadvantage of LDFs is that the flow rate through them is considerably slower and therefore clinicians may need to assess the benefit of faster transfusion treatment without LDF vs. its use. In summary, despite the theoretical risks and benefits, there is no conclusive evidence that CS can induce metastases or affect cancer prognosis [55]. The theoretical risk of inducing metastatic spread (unproven) is outweighed by reduced allogeneic transfusion and immunomodulation, which is proven. As a result, many doctors offer cell rescue for patients undergoing major surgery. The separate work recommends that potential risks and benefits be discussed with patients prior to cancer surgery, and specific consent obtained. Infected and contaminated fields There is no absolute contraindication for CS in this scenario. Its use is, however, controversial, as CS can (theoretically) worsen sepsis by introducing recovered agents and toxins into the operative field. On the other hand, CS reduces exposure to allogeneic blood, which can increase the incidence of postoperative infection through immunomodulation [56, 57]. Washing blood samples and the use of LDFs removes most bacteria, but this effect is likely dependent on the level of contamination [58]. There is no conclusive evidence that CS worsens sepsis, prognosis, or the risk of other specific diseases and complications when used in contaminated fields, including major trauma surgery. We recommend that the use of cell recovery in cancer surgery and infected fields should be considered on a case-by-case basis. Whenever possible. Patients in whom cells are saved is used, and should be counseled and asked if they consent to the procedure being used. Leucodepletion filters must be used for blood reinfusion.

Long-Term Safety of Autotransfusion During Hepatectomy for Hepatocellular Carcinoma (oncologia)

Autotransfusion promoted survival in patients undergoing hepatectomy for stage I or II HCC.

Phase II comparison study of intraoperative autotransfusion for major oncologic procedures. (oncologia)

Intraoperative autotransfusion can be used safely and effectively for major oncologic procedures. In addition, the degree of anemia at discharge is associated with a lower quality of life in patients undergoing gastrointestinal oncologic surgery.