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

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review

16 Scopus Citations
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Author(s)

  • Naresh Kumar
  • Aye Sandar Zaw
  • Sayantani Nandi
  • Zhangxing Lai
  • Gurpal Singh
  • Chwee Teck Lim
  • Jean Paul Thiery

Detail(s)

Original languageEnglish
Pages (from-to)4008-4015
Journal / PublicationEuropean Spine Journal
Volume25
Issue number12
Online published7 Mar 2016
Publication statusPublished - Dec 2016
Externally publishedYes

Abstract

Purpose This study aimed at evaluating our hypothesis that tumour cells, which pass through the intraoperative cell salvage (IOCS) machine, lose viability due to possible injury to the cell membrane during centrifugation and filtration, enabling safe reinfusion even without filtration. 
Methods Thirteen patients who underwent metastatic spine tumour surgery (MSTS) at our institution were recruited. Blood samples (5 ml each) were collected at five different stages during surgery, namely, stage A and B: from patients’ vein during induction and at the time of maximum tumour manipulation; stage C, D and E: from the operative blood prior to IOCS processing, after IOCS processing and after IOCS-LDF (leucocyte depletion filter) processing, respectively. The samples were then analysed for viability of tumour cells using microwell-based culture. 
Results The median age of the patients was 65 years (range 37–77 years). The most common primary tumour was lung, followed by breast, hepatocellular and renal cell carcinoma. The median blood loss was 680 ml (range 300–1500 ml). Analysis of cultured blood samples showed that CTC-containing clusters were developed from some samples before IOCS-LDF processing (stage A: three patients, stage B: three patients and stage C: one patient). None of the samples from stages D and E generated clusters after culture, suggesting the absence of viable cancer cells after IOCS processing. 
Conclusions The salvaged blood may contain some tumour cells after processing with IOCS machine, but these cells are damaged and hence unable to replicate and unlikely to metastasise. The results of this study support the hypothesis that salvaged blood in MSTS is safe for transfusion.

Research Area(s)

  • Circulating tumour cells (CTCs), Intraoperative cell salvage, Leucocyte depletion filter, Metastatic spine tumour surgery, Microwells

Citation Format(s)

Intraoperative cell salvage in metastatic spine tumour surgery reduces potential for reinfusion of viable cancer cells. / Kumar, Naresh; Zaw, Aye Sandar; Khoo, Bee Luan et al.

In: European Spine Journal, Vol. 25, No. 12, 12.2016, p. 4008-4015.

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review