scholarly journals The safety, efficacy and cost-effectiveness of intraoperative cell-salvage in metastatic spine tumour surgery

2016 ◽  
Vol 16 (4) ◽  
pp. S61-S62
Author(s):  
Mahmoud Elmalky ◽  
Naveed Yasin ◽  
Ricardo Pinto ◽  
John Stephenson ◽  
Craig Carroll ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cell Salvage ◽  
Intraoperative Cell Salvage ◽  
Metastatic Spine Tumour Surgery ◽  
Spine Tumour

Intraoperative cell salvage in metastatic spine tumour surgery reduces potential for reinfusion of viable cancer cells

2016 ◽  
Vol 25 (12) ◽  
pp. 4008-4015 ◽  
Author(s):  
Naresh Kumar ◽  
Aye Sandar Zaw ◽  
Bee Luan Khoo ◽  
Sayantani Nandi ◽  
Zhangxing Lai ◽  
...  
Keyword(s):  
Cancer Cells ◽  
Cell Salvage ◽  
Intraoperative Cell Salvage ◽  
Metastatic Spine Tumour Surgery ◽  
Spine Tumour

scholarly journals Effectiveness of Intraoperative Cell Salvage Combined with a Modified Leucocyte Depletion Filter in Metastatic Spine Tumour Surgery

2022 ◽  
Author(s):  
Ya-nan Zong ◽  
Chuan-ya Xu ◽  
Yue-qing Gong ◽  
Xiao-qing Zhang ◽  
Hong Zeng ◽  
...  
Keyword(s):  
Tumour Cells ◽  
Residual Tumour ◽  
Cell Salvage ◽  
Clinical Trial Registry ◽  
Blood Samples ◽  
Intraoperative Cell Salvage ◽  
Significant Difference ◽  
Metastatic Spine Tumour Surgery ◽  
Leucocyte Depletion Filter ◽  
Spine Tumour

Abstract Background To compare the effectiveness of intraoperative cell salvage (IOCS) combined with a modified leucocyte depletion filter (MLDF) with IOCS combined with a regular leucocyte depletion filter (RLDF) in eliminating tumour cells from blood salvage during metastatic spine tumour surgery (MSTS). Methods Patients with a known primary epithelial tumour who underwent MSTS were recruited for this study. Blood samples were collected in 5 stages: from the patients’ vein before anaesthesia induction (S1), from the operative field during tumour manipulation (S2), and from the operative blood after IOCS processing (S3) and after IOCS+RLDF (S4) and IOCS+MLDF (S5) processing. The polyploids of tumour cells in the blood samples were collected and counted with immunomagnetic separation enrichment and fluorescence in situ hybridization. Results We recruited 20 patients. Tumour cells were detected in 14 patients (70%) in S1, 16 patients (80%) in S2, 13 patients (65%) in S3, and 12 patients (60%) in S4. MLDF was added in 8 patients. Tumour cells were detected in only 1 of 8 patients in S5 (12.5%). There were significantly fewer tumour cells in the samples collected after MLDF processing (S5) than in the samples collected after RLDF (S4) and around the tumour (S2) (P = 0.016 and P = 0.039, respectively). Although no significant difference was observed between S4 and S1, a downward trend was observed after IOCS+RLDF processing. Conclusions Tumour cells could be removed by IOCS combined with RLDF from blood salvaged during MSTS, but residual tumour cells remained. The findings support the notion that MLDF eliminates tumour cells more effectively than RLDF. Hence, this technique can be applied to MSTS. Trial Registration ChiCTR1800016162 Chinese Clinical Trial Registry http://www.chictr.org.cn/showproj.aspx?proj=27263

scholarly journals The safety, efficacy, and cost-effectiveness of intraoperative cell salvage in metastatic spine tumor surgery

2017 ◽  
Vol 17 (7) ◽  
pp. 977-982 ◽  
Author(s):  
Mahmoud Elmalky ◽  
Naveed Yasin ◽  
Ricardo Rodrigues-Pinto ◽  
John Stephenson ◽  
Craig Carroll ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Tumor Surgery ◽  
Cell Salvage ◽  
Spine Tumor ◽  
Intraoperative Cell Salvage ◽  
Metastatic Spine Tumor ◽  
Spine Tumor Surgery

scholarly journals Efficacy of Intraoperative Blood Salvage in Cerebral Aneurysm Surgery

2021 ◽  
Vol 10 (24) ◽  
pp. 5734
Author(s):  
Bedjan Behmanesh ◽  
Florian Gessler ◽  
Elisabeth Adam ◽  
Ulrich Strouhal ◽  
Sae-Yeon Won ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Blood Cell ◽  
Cerebral Aneurysm ◽  
Red Blood Cell ◽  
Cerebral Aneurysms ◽  
Cell Salvage ◽  
Aneurysm Surgery ◽  
Allogenic Blood ◽  
Intraoperative Cell Salvage ◽  
Unruptured Cerebral Aneurysm

Background. The use and effectiveness of intraoperative cell salvage has been analyzed in many surgical specialties. Until now, no data exist evaluating the efficacy of intraoperative cell salvage in cerebral aneurysm surgery. Aim. To evaluate the efficacy and cost effectiveness of intraoperative cell salvage in cerebral aneurysm surgery. Methods. Data were collected retrospectively for all the patients who underwent cerebral aneurysm surgery at our institution between 2013 and 2019. Routinely, we apply blood salvage through autotransfusion. The cases were divided into a ruptured cerebral aneurysm group and a unruptured cerebral aneurysm group. Results. A total of 241 patients underwent cerebral aneurysm clipping. Of all the cerebral aneurysms, 116 were ruptured and 125 were unruptured and clipped electively. Age, location of the aneurysm, postoperative red blood cell count, intraoperative blood loss, and number of allogenic blood cell transfusions were statistically significantly different between the groups. The autotransfusion of salvaged blood could only be facilitated in eight cases with ruptured cerebral aneurysms and in none with unruptured cerebral aneurysms clipped electively (p < 0.01). Additionally, 35 patients with ruptured cerebral aneurysms and one patient with unruptured cerebral aneurysm required allogenic red blood cell transfusion after surgery, and 71 vs. 2 units of blood were transfused (p < 0.0001). In terms of cost effectiveness, a total of EUR 45,189 in 241 patients was spent to run the autotransfusion system, while EUR 13,797 was spent for allogenic blood transfusion. Conclusions. The use of cell salvage in patients with unruptured cerebral aneurysm, undergoing elective surgery, is not effective.

scholarly journals Evaluation of the Feasibility of Transfusing Leucocyte Depletion Filter (LDF) Processed Intra-Operative Cell Salvage (IOCS) Blood in Metastatic Spine Tumour Surgery (MSTS): Protocol for a Non Randomised study (Preprint)

2019 ◽  
Author(s):  
Naresh Kumar ◽  
Jiong Hao Tan ◽  
Nivetha Ravikumar ◽  
Joel Yong Hao Tan ◽  
Helena Milavec ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Disease Progression ◽  
Tumour Progression ◽  
Rank Test ◽  
Control Group ◽  
Healthcare Intervention ◽  
Cell Salvage ◽  
Blood Management ◽  
Metastatic Spine Tumour Surgery ◽  
Spine Tumour

BACKGROUND Metastatic Spine Tumour Surgery (MSTS) is often complex and extensive leading to significant blood loss. Allogeneic blood transfusion (ABT) is mainstay of blood replenishment but with immune-mediated post-operative complications. Alternative blood management techniques (salvaged blood transfusion (SBT)) allow us to overcome such complications. Despite widespread use of intra-operative cell salvage (IOCS) in oncological and non-oncological surgeries, surgeons remain reluctant to employ IOCS in MSTS. OBJECTIVE This study will analyse the safety of IOCS-LDF processed blood transfusion to patients undergoing MSTS by assessing clinical outcomes – disease progression: tumour progression and overall survival (OS). We will also evaluate whether reinfusion of IOCS-LDF processed blood can reduce the ABT rates in patients undergoing MSTS by comparing the proportion of MSTS patients requiring ABT in those patients who consent to receive SBT, and those who do not consent for SBT. METHODS We aim to recruit 90-patients (minimum)-30 SBT, 30 ABT and 30 with no blood transfusion (NBT). SBT and ABT form the two experimental arms, while NBT forms the control cohort. All available patient data will be reviewed to determine tumour burden secondary to metastasis and post-operative survival and/or disease progression, improvement in pain, neurology and ambulatory status. Collected data will be studied at 3, 6, 12 and 24 months post-operatively, or until demise, whichever occurs first. Collected outcomes of the experimental groups will be compared with that of the control group. Statistical Analysis: Outcomes will be analysed using one-way ANOVA and Fisher’s exact test. OS will be studied by Kaplan-Meier curve and log rank test. Multivariate and competing risk analysis will be used to study the association between blood transfusion type and tumour progression. All statistical analyses will be done using STATA/SE14.0 RESULTS This is the first clinical study on the use of IOCS in MSTS from various primary malignancies. It will provide major clinical evidence regarding safety and applicability of IOCS in MSTS. It will help reduce ABT usage; thus improving overall blood management of MSTS patients. However, limitation of this study is that not all patients undergoing MSTS will survive for the total follow-up period (two years), thereby theoretically leading to under-reporting of disease progression. CONCLUSIONS Results will be disseminated via peer-reviewed publications and will pave the way for future studies CLINICALTRIAL This study did not involve a healthcare intervention and hence, did not need to be registered

scholarly journals Clinical efficacy and cost effectiveness of intraoperative cell salvage in pelvic trauma surgery

2013 ◽  
Vol 95 (5) ◽  
pp. 357-360 ◽  
Author(s):  
S Odak ◽  
A Raza ◽  
N Shah ◽  
A Clayson
Keyword(s):  
Cost Effectiveness ◽  
Blood Loss ◽  
Clinical Efficacy ◽  
Fracture Fixation ◽  
Trauma Surgery ◽  
Conservation Strategy ◽  
Cell Salvage ◽  
Surgical Interventions ◽  
Intraoperative Cell Salvage ◽  
The Mean

Introduction Pelvic acetabular injuries are associated with significant blood loss. This is compounded by multiple surgical interventions including definitive fracture fixation, which put patients at further risk of postoperative transfusion. We use intraoperative cell salvage routinely as a blood conservation strategy to address this issue. This is a prospective evaluation of the clinical efficacy and cost effectiveness of using intraoperative cell salvage in patients with pelvic acetabular injuries. Methods Data were collected prospectively for all the patients who underwent pelvic acetabular fracture fixation at our institution. A total of 30 patients (25 men, 5 women) with a mean age of 41 years (range: 31–79 years) were assessed over a period of 10 months. Results The mean preoperative and postoperative haemoglobin levels were 11.8g/dl and 9.9g/dl respectively. The mean intraoperative blood loss was 1,232.5ml (range: 150–2,693ml). The mean amount of blood salvaged and retransfused through a cell saver was 388ml. Of the 30 patients, 14 (47%) required transfusion after surgery and 26 units of blood were transfused. In terms of cost effectiveness, a total of £2,572 in 30 patients or £86 per patient were saved. Conclusions We found intraoperative cell salvage to be clinically efficacious and cost effective in patients with pelvic acetabular injuries.

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