title: Modified Leukocyte Filter Removes Tumor Cells from the Salvaged Blood.
abstract: BACKGROUND
  Intraoperative blood salvage, an effective blood conservation strategy, has not been applied in onco-surgery, because of potential malignant cell contamination. In this study we tested effectiveness of a modified leukocyte depletion filter (M-LDF) for removal of tumor cells.
  
  
  METHODS
  The effects of M-LDF and regular LDF on removal of cells (HepG2 cell line) were compared. The safety of M-LDF was tested with blood (collected and washed during onco-surgery), the salvaged blood mixed with tumor cells from the solid tumor of the same patient, or mixed with HepG2 cells (n=30 in each protocol). Cancer cells were identified by flow cytometry, culture and bioassay with and without filtration.
  
  
  RESULTS
  M-LDF removed 5-log of HepG2 and nucleated cells, which was much higher than regular LDF, and cells were destroyed when they passed through M-LDF. Cytokeratin-positive cells in all samples were removed by M-LDF. Invasive growth adherent cells were found in most of unfiltered samples and 67% of the inoculated nude mice developed tumors in LDF-treated sample. Neither adherent cells nor nude mice developed tumors were found in M-LDF-treated samples.
  
  
  CONCLUSIONS
  Since M-LDF can effectively remove and destroy cancer cells in the salvaged blood, it has great potential for clinical application.
authors.affiliation: Department of Medical Oncology, Sichuan Cancer Hospital, Chengdu, Sichuan, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Mei
authors.affiliation: Department of Anesthesiology and Translational Neuroscience Centre, West China Hospital, Chengdu, Sichuan, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Du
authors.affiliation: Department of Anesthesiology, Affiliated No. 2 Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Min
authors.initials: M
authors.lastname: Yan
authors.affiliation: Department of Anesthesiology, Sichuan Cancer Hospital, Chengdu, Sichuan, China.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, Affiliated No. 2 Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Fengjiang
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology and Translational Neuroscience Centre, West China Hospital, Chengdu, Sichuan, China.
authors.forename: Lina
authors.initials: L
authors.lastname: Gong
authors.affiliation: Department of Anesthesiology, Affiliated No. 2 Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Sun
authors.affiliation: Key Laboratory of Transplant Engineering and Immunology, Ministry of Health and West China Hospital, Sichuan, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, Sichuan Cancer Hospital, Chengdu, Sichuan, China.
authors.forename: Yumin
authors.initials: Y
authors.lastname: Tang
authors.affiliation: Department of Anesthesiology and Translational Neuroscience Centre, West China Hospital, Chengdu, Sichuan, China.
authors.forename: Chunling
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Anesthesiology and Translational Neuroscience Centre, West China Hospital, Chengdu, Sichuan, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Liu
mesh_terms: D000818:Animals; D005374:Filtration / Q000295:instrumentation*; D005434:Flow Cytometry; D056945:Hep G2 Cells; D006801:Humans; D047589:Leukocyte Reduction Procedures / Q000295:instrumentation*; D051379:Mice; D009360:Neoplastic Cells, Circulating; D057725:Operative Blood Salvage / Q000295:instrumentation* / Q000379:methods