Intraoperative autotransfusion in urologic oncology
I. Klimberg, R. Sirois, Z. Wajsman and J. Baker
The value of autotransfusion is widely recognized in the surgical community
and may be of increasing importance in prevention of acquired
immunodeficiency syndrome and hepatitis. The concern of potential
contamination of the blood with viable tumor cells has resulted in limited
use of autotransfusion in cancer surgery. The objective of this study was
to examine the benefits and safety of autotransfusion in patients
undergoing major surgery of genitourinary tumors. Autotransfusion was used
in 49 consecutive patients. Twenty-four patients had radical cystectomy,
ten had radical prostatectomy, 13 had radical nephrectomy, and two had
other types of operations. An autotransfusion machine (Haemonetics Cell
Saver) was used. The follow-up included physical examination, chest
roentgenogram every three months, and bone scan and computed tomographic
scan if clinically indicated. Liver and renal profiles were routinely
performed every three months. Five of 49 patients developed metastases
during follow-up examination from 12 to 23 months. The low incidence of
metastatic spread and the pattern of spread fall to implicate
autotransfusion as a cause of tumor dissemination. Autotransfusion and
predeposited blood banking may result in elimination of or significant
reduction in homologous transfusions.
