doi:10.1016/S0090-4295(99)80411-7
Copyright © 1996 Published by Elsevier Inc.

The potential for reintroduction of tumor cells during intraoperative blood salvage: Reduction of risk with use of the RC-400 leukocyte depletion filter^*



Martin J. Edelman^{a, b, c, d, e,} , Paul Potter^{a, b, c, d, e}, Kevin G. Mahaffey^{a, b, c, d, e}, Richard Frink^{a, b, c, d, e} and Raymond B. Leidich<sup>a, b, c, d, e

a</sup>From the Division of Hematology/Oncology, Veterans Affairs Northern California Health Care System, University of California, Davis School of Medicine, USA
^bFrom the Department of Anesthesia, Naval Medical Center, San Diego, California, USA
^cFrom the Department of Urology, U.S. Naval Hospital, Guam, USA
^dFrom the Department of Urology, Naval Medical Center, Oakland, California, USA
^eFrom the Department of Urology, Texas Tech, School of Medicine, Lubbock, Texas, USA

Received 18 August 1995; revised 16 October 1995; accepted 16 October 1995. Available online 1 February 2001.




Abstract

Objectives



Intraoperative autotransfusion of shed blood is widely utilized in surgery. However, several studies have raised concern about the transmission of tumor cells during oncologic procedures. We compared the ability of a leukocyte depletion filter (RC-400; LDF) to a standard red blood cell filter (SBF) to remove tumor cells derived from urologic malignancies. Methods



Cells were suspended in media and passed through a SBF or a LDF. The filtrate was evaluated for the presence of viable cells utilizing the trypan blue exclusion method as well as cell culture. In a second experiment, cells were suspended in fresh bovine blood and processed through a cell saver apparatus followed by filtration with either a SBF or a LDF. Aliquots were cultured after admixture with blood, after processing, and after filtration. Results



The LDF was able to remove tumor cells completely, as demonstrated by both counting with the trypan blue exclusion test and by cell culture. In contrast, admixture with blood, processing through the cell saver apparatus nor a standard red blood cell filter removed these cells. Conclusions

Tumor cells derived from urologic malignancies are easily removed with a LDF but not with a SBF. Filtration of blood salvaged at the time of uro-oncologic surgery with a LDF but not with a SBF reduces the potential for reinfusion of viable tumor cells, urology ^® 47: 179-181, 1996.






^*This study was performed in the Clinical Investigation Division of the Naval Medical Center Oakland, Oakland, Calif.
Reprint requests: Martin J. Edelman, M.D., Division of Hematology/Oncology (111H), Veterans Affairs Outpatient Clinic, 150 Muir Road, Martinez, CA 94553.