AUTOLOGOUS TRANSFUSION IN TUMOR SURGERY

Objective: The potential and limits of autologous transfusion in tumor patients are discussed according to the literature. New aspects are d erived from own recent studies. Data Sources and Selection Criteria: T he 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 repr esents an important and practical alternative to homologous transfusio n also for tumor patients. Predeposit programs are limited by tumor an emia, the urgent time schedule for surgery, and the variable need for transfusions. Intraoperative autotransfusion is contraindicated in the se patients. Our own studies on the presence of tumor cells in the blo od shed from the surgical field during oncologic surgery confirm the c oncerns about a systemic spread of tumor cells after retransfusion. Fu rther efforts aim to an elimination of contaminating tumor cells. In c ontrast to the literature filters for white blood cell depletion were found to fail to completely remove tumor cells. A 3 log(10) retention was measured. Proliferative activity of tumor cells was completely abo lished by irradiation of the blood. Conclusions: Irradiation with 50 G y allows safe retransfusion of blood salvaged during tumor surgery. Th is promising possibility is now to be tested in clinical studies.