[Experimental principles and general practice of intraoperative autotransfusion with blood irradiation in tumor...

Clinical studies fail to verify or to exclude the lethal risk of tumor spread after intraoperative autotransfusion in tumor surgery. An alternative approach is the development of methods for the elimination of tumor cells in the salvaged blood. The radiosensitivity of tumor cells especially in oxygenated single cell suspensions is well known, while the non-nucleated red blood cells are radioresistant. With 50 Gy a 12 log reduction in proliferating cells is expected. This we have tested experimentally and put into clinical practice. The suppression of colony formation in cell culture by irradiation with 50 Gy was tested with tumor cells from established cell lines or from solid tumors after admixture in high cell number to red blood cells from volunteer blood donations. DNA metabolism was tested by incorporation of bromodesoxyuridine (BrdUrd) and staining with mcab-anti-BrdUrd. Colony formation and DNA metabolism was absent in all samples of cell lines or tumor cells in blood after irradiation with 50 Gy, reflecting a 10 log, or 7 log reduction, respectively. In clinical practice the method of intraoperative blood salvage during tumor surgery with blood irradiation showed its practicability and efficacy in reducing homologous transfusions.