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Intraoperative Cell Salvage in Oncologic Surgery: A Comprehensive Review
Ward H van der Ven1, Markus W Hollmann1,2
1Department of Anesthesiology, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Intraoperative cell salvage (ICS) is safe and effective in cancer surgery, despite concerns about tumor cell reinfusion. Guidelines support its use to reduce risks associated with allogeneic blood transfusions.
Area of Science:
- Oncology
- Surgical Innovation
- Blood Conservation
Background:
- Intraoperative cell salvage (ICS) is a blood conservation method.
- Its use in oncologic surgery is debated due to metastasis concerns.
- Allogeneic blood transfusion (ABT) carries risks like transfusion reactions and immunosuppression.
Purpose of the Study:
- To review the safety and efficacy of ICS in oncologic procedures.
- To evaluate the risk of tumor cell metastasis with ICS.
- To compare ICS benefits against ABT risks.
Main Methods:
- Review of historical development and technical processes of ICS.
- Analysis of in vitro, experimental, and clinical data on ICS.
- Synthesis of findings from systematic reviews and guidelines.
Main Results:
- In vitro studies show tumor cell structural changes during ICS processing.
- Filtration reduces but may not eliminate tumor cells.
- Observational studies show no increased recurrence or reduced survival with ICS.
Conclusions:
- ICS appears effective and safe for oncologic surgery.
- National and international guidelines endorse ICS use.
- Broader adoption of ICS may be warranted to minimize ABT reliance.
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