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

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 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

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

Metastatic efficiency of tumour cells can be impaired by intraoperative cell salvage process: truth or conjecture?

2017 ◽  
Vol 27 (5) ◽  
pp. 327-334 ◽  
Author(s):  
N. Kumar ◽  
A. S. Zaw ◽  
S. B. Kantharajanna ◽  
B. L. Khoo ◽  
C. T. Lim ◽  
...  
Keyword(s):  
Tumour Cells ◽  
Cell Salvage ◽  
Intraoperative Cell Salvage

Markers of Hemostatic Activation in Affected Coronary Arteries during Angioplasty

1994 ◽  
Vol 72 (05) ◽  
pp. 672-675 ◽  
Author(s):  
Nicolas W Shammas ◽  
Michael J Cunningham ◽  
Richard M Pomearntz ◽  
Charles W Francis
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Venous Blood ◽  
Balloon Inflation ◽  
Blood Samples ◽  
Hemostatic System ◽  
Significant Difference ◽  
Hemostatic Markers ◽  
Artery Disease ◽  
High Doses

SummaryTo characterize the extent of early activation of the hemostatic system following angioplasty, we obtained blood samples from the involved coronary artery of 11 stable angina patients during the procedure and measured sensitive markers of thrombin formation (fibrino-peptide A, prothrombin fragment 1.2, and soluble fibrin) and of platelet activation ((3-thromboglobulin). Levels of hemostatic markers in venous blood obtained from 14 young individuals with low pretest probability for coronary artery disease were not significantly different from levels in venous blood or intracoronary samples obtained prior to angioplasty. Also, there was no translesional (proximal and distal to the lesion) gradient in any of the hemostatic markers before or after angioplasty in samples obtained between 18 and 21 min from the onset of the first balloon inflation. Furthermore, no significant difference was noted between angioplasty and postangioplasty intracoronary concentrations. We conclude that intracoronary hemostatic activation does not occur in the majority of patients during and immediately following coronary angioplasty when high doses of heparin and aspirin are administered.

Effect of Concentration of Trisodium Citrate Anticoagulant on Calculation of the International Normalised Ratio and the International Sensitivity Index of Thromboplastin

1994 ◽  
Vol 72 (01) ◽  
pp. 084-088 ◽  
Author(s):  
E M Duncan ◽  
C R Casey ◽  
B M Duncan ◽  
J V Lloyd
Keyword(s):  
Reference Material ◽  
Oral Anticoagulants ◽  
Reference Method ◽  
Trisodium Citrate ◽  
Sensitivity Index ◽  
Blood Samples ◽  
Orthogonal Regression ◽  
Significant Difference ◽  
International Normalised Ratio ◽  
International Sensitivity Index

SummaryThe aim of this study was to determine whether the concentration of trisodium citrate used to anticoagulate blood has an effect on the INR of the sample and the ISI of the thromboplastin. Five thromboplastins including and Australian reference material were used to measure the prothrombin time of normal and patient samples collected into two concentrations of trisodium citrate - 109 mM and 129 mM. There was no effect of citrate concentration on the INRs determined with the reference material. However for the other four thromboplastins there was a significant difference between INRs for the two citrate groups. The prothrombin times of the samples collected into 129 mM were longer than those collected into 109 mM. This difference was only slight in normal plasma but more marked in patients receiving oral anticoagulants, causing the INRs for patient plasmas collected into 129 mM citrate to be higher then the corresponding samples collected into 109 mM citrate.From orthogonal regression of log prothrombin times by the reference method against each thromboplastin, we found that the ISI for each thromboplastin was approximately 10% lower when determined with samples collected into 129 mM citrate than with samples collected into 109 mM. These results suggest that the concentration of trisodium citrate used for collection of blood samples can affect the calculation of the INR and the calibration of the ISI of thromboplastin. This was found both for commercial thromboplastins prepared by tissue extraction and for a recombinant tissue factor.

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