[Autologous blood transfusion in tumor operations]

Abstract

Objective: The potential and limits of autologous transfusion in tumor patients are discussed according to the literature. New aspects are derived from own recent studies.

Data sources and selection criteria: The critical review of the German and English literature is based on a Medline and DIMDI backsearch covering the last 20 years. Own data not yet published are presented.

Results: Predeposit autologous blood represents an important and practical alternative to homologous transfusion also for tumor patients. Predeposit programs are limited by tumor anemia, the urgent time schedule for surgery, and the variable need for transfusions. Intraoperative autotransfusion is contraindicated in these patients. Our own studies on the presence of tumor cells in the blood shed from the surgical field during oncologic surgery confirm the concerns about a systemic spread of tumor cells after retransfusion. Further efforts aim to an elimination of contaminating tumor cells. In contrast to the literature filters for white blood cell depletion were found to fail to completely remove tumor cells. A 3 log10 retention was measured. Proliferative activity of tumor cells was completely abolished by irradiation of the blood.

Conclusions: Irradiation with 50 Gy allows safe retransfusion of blood salvaged during tumor surgery. This promising possibility is now to be tested in clinical studies.