Cytological and bacteriological studies of intraoperative autologous blood in neurosurgery.
BACKGROUND
To ensure the safety of salvaged blood in neurologic surgery, reinfused blood through the Cell Saver System (CSS) (Hemonetics) was investigated cytologically and bacteriologically.


METHODS
Specimens of reinfused blood were cytologically examined with Papanicolaou or Giemsa stains. Reinfused blood and air in the operating theater were investigated by microbiologic techniques. The concentration of dust particles in the theater was determined.


RESULTS
Tumor cells were positive in reinfused blood in 5 of 9 specimens with glioblastoma, in 2 of 8 with pituitary adenoma, and 1 of 13 with meningioma. The probability of migration of meningioma cells into reinfused blood was significantly low in comparison with that of glioma cells. Of the 30 specimens studied microbiologically, the bacterial growth was detected in salvaged blood of 14 specimens (46.7%) and in the air of the operating theater for 8 specimens (26.7%). In craniotomy, the contamination rate was 10 of 26 specimens of reinfused blood (38.5%). Most microorganisms were found to be staphylococci. No statistically significant correlation could be found between salvaged blood and air as to contamination or between reinfused blood and the concentration of dust particles in the theater as to bacteriologic results. No infectious complications were found after the operation, though salvaged blood through the CSS was reinfused in 37 patients without glioblastoma or transsphenoidal approach.


CONCLUSIONS
The CSS cannot always entrap tumor cells. Salvaged blood should not be reinfused in the patients with glioblastoma or transsphenoidal surgery. None of the patients with reinfusion had any infectious complications. Reinfusion of salvaged blood seems to be safe in neurosurgery.
Kudo
Hiroshi
H
Departments of Neurosurgery and Anesthesiology, Rokko Island Hospital, Kobe, Japan.
Fujita
Hiroki
H
Hanada
Yusei
Y
Hayami
Hiroshi
H
Kondoh
Takeshi
T
Kohmura
Eiji
E
D001769:Blood / Q000382:microbiology*; D001804:Blood Transfusion, Autologous; D001932:Brain Neoplasms / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D016972:Enterobacter cloacae / Q000302:isolation & purification; D006440:Hemofiltration; D006801:Humans; D020765:Intracranial Arterial Diseases / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D009360:Neoplastic Cells, Circulating; D019635:Neurosurgical Procedures; D013210:Staphylococcus / Q000302:isolation & purification; D034363:Viridans Streptococci / Q000302:isolation & purification