CS in cancer patients

Q: Patients with active malignancy should not receive Cell Saver (CS) blood during surgery, as it may increase the chances of metastasis.

A) True

B) False

Answer: B

Intraoperative blood salvage technique is popular in all surgical cases where high blood loss is anticipated. Previously, patients with active malignancy were considered high risk for CS, as theoretically, the chances of spread of malignancy may be high. But evidence failed to prove such a notion. CS technique can be successfully used in surgery for patients with active malignancy.

Consider adding leukocyte-reduction filters, as studies have shown they remove tumor cells from salvaged blood.

#hematology

#procedures

References: 

1. Waters JH, Yazer M, Chen YF, Kloke J. Blood salvage and cancer surgery: a meta-analysis of available studies. Transfusion 2012; 52:2167.

2. Kumar N, Tan JYH, Chen Z, et al. Intraoperative cell-salvaged autologous blood transfusion is safe in metastatic spine tumour surgery: early outcomes of prospective clinical study. Eur Spine J 2023; 32:2493.

3. Frietsch T, Steinbicker AU, Horn A, et al. Safety of Intraoperative Cell Salvage in Cancer Surgery: An Updated Meta-Analysis of the Current Literature. Transfus Med Hemother 2022; 49:143.

4. Kumar N, Lam R, Zaw AS, et al. Flow cytometric evaluation of the safety of intraoperative salvaged blood filtered with leucocyte depletion filter in spine tumour surgery. Ann Surg Oncol 2014; 21:4330.