ELIMINATION OF OSTEOSARCOMA CELLS DURING INTRAOPERATIVE AUTOTRANSFUSION BY LEUKOCYTE DEPLETION FILTERS

Intraoperative autotransfusion is contraindicated in cancer surgery be cause of the possible risk of systemic tumor spread. The aim of the pr esent study was to investigate whether a cell saver in combination wit h a white blood cell depletion filter can remove osteosarcoma cells. M ethods. A defined number of osteosarcoma cells from an established cel l line were added to red cell concentrates and Ringer solution. The tu mor cell concentration was 1000/ml in the first five experiments, 7111 /ml in test no. 6, 1667/ml in test no. 7 and 167/ml in test no. 8. Fol lowing thorough mixing, each unit was processed separately by a cell s aver (DIDECO BT 795/P) in its normal operation mode to produce a red c ell concentrate. This red cell concentrate was leukocyte depletion fil ter (PALL BPF 4). Samples were taken before and after processing with the auto-transfuser and after filtration with the white cell depletion filter. Cytospin specimens from all samples were examined for osteosa rcoma cells by three different methods (Papanicolaou stain, Vimentin a ntibodies, DNA analysis). Results. After processing with the autotrans fuser, tumor cells were identified in the red cell concentrate. No ost eosarcoma cells were evident after the combined use of cell saver and leukocyte depletion filter. Conclusion. The sole use of the autotransf user DIDECO BT 795/P during osteosarcoma surgery is not recommended be cause of the potential danger of retransfusion of malignant cells. In combination with the leukocyte depletion filter PALL BPF 4, no osteosa rcoma cells were identified in the red cell concentrate. Since the adh esiveness of tumor cells from established cell lines may be different from that of tumor cells in the intraoperative salvaged blood, further studies with blood from the surgical field are necessary to determine the efficacy of white cell depletion filters to eliminate osteosarcom a cells.