title: Is Autologous Salvaged Blood a Viable Option for Patient Blood Management in Oncologic Surgery?
abstract: Oncologic surgery is sometimes associated with substantial blood loss, and principles of patient blood management can be applied in the perioperative care of these patients. Although autologous salvaged blood is an option for perioperative blood conservation, it is often not used in oncologic surgery over concern of reinfusing tumor cells and thereby causing tumor dissemination. We reviewed the literature regarding safety and effectiveness of salvaged blood in oncologic surgery. Salvaged blood seems to be comparable to allogeneic blood in terms of safety. Because patients with primary or metastatic cancer are known to have circulating tumor cells in the absence of surgery, the concern of reinfusing malignant cells from the salvaged blood may be overstated. Reinfusion of salvaged blood has not been found to promote tumor dissemination or distant metastases. When used in patients with substantial blood loss, salvaged blood can be cost-effective. Intraoperative salvaged blood may be a useful adjunct to allogeneic blood resources.
authors.affiliation: Department of Orthopaedic Surgery, National University Health System, Singapore, Singapore.
authors.forename: Aye Sandar
authors.initials: AS
authors.lastname: Zaw
authors.affiliation: Department of Orthopaedic Surgery, National University Health System, Singapore, Singapore.
authors.forename: Shashidhar
authors.initials: S
authors.lastname: Bangalore Kantharajanna
authors.affiliation: Department of Orthopaedic Surgery, National University Health System, Singapore, Singapore. Electronic address: dosksn@nus.edu.sg.
authors.forename: Naresh
authors.initials: N
authors.lastname: Kumar
mesh_terms: D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000379:methods; D006801:Humans; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D057725:Operative Blood Salvage / Q000009:adverse effects / Q000379:methods; D019990:Perioperative Care / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: Circulating tumor cells; Metastasis; Oncologic surgery; Primary cancer; Salvaged blood; Tumor cells