Pak K, Kim C J, Konishi T, Yoshiki T, Tomoyoshi T, Moro K, Tatewaki K, Iwai M, Miyahira Y, Okabe H
Department of Urology, Shiga University of Medical Science.
Nihon Hinyokika Gakkai Zasshi. 1991 Dec;82(12):1972-7. doi: 10.5980/jpnjurol1989.82.1972.
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 possible contamination of the blood with urine, bacteria in urine or viable tumor cells has limited the wide use of intraoperative autotransfusion (IAT) in urological operation. There have been no experimental reports about protection of the blood from such contamination. To investigate separation of the blood from a contaminated mixture by using an autotransfusion machine, Haemonetic Cell Saver, a study composed of three experiments was performed. First, 200 ml of blood was mixed 200 ml of urine, and thereafter, the mixture was processed by the machine and the concentration erythrocytes were collected in a bag. Biochemical analysis of the collected erythrocyte solution (CES) was performed. Second, 200 ml of blood was mixed with 200 ml of urine that was adjusted to contain each 10(7)/ml of four bacterial strains. The bacteriological study of the CES was performed. Third, 200 ml of blood was mixed with 200 ml of urine that was adjusted to contain 10(7) cancer cells. Two cell lines, KK47 originated from human bladder cancer and ACHN originated from human renal cell carcinoma was used. The cytological study of the CES was performed. The results of these experiments were: Urine constituents were completely removed from the mixture. However, all strains of bacteria could not be separated, although the number of bacteria decreased. Cancer cells were found in the CES. In conclusion IAT should be done at urological operation in selected patients that have sterile urine and do not have tumor cells in the operation field.
自体输血的价值在外科领域已得到广泛认可，在预防获得性免疫缺陷综合征和肝炎方面可能愈发重要。对血液可能被尿液、尿液中的细菌或存活的肿瘤细胞污染的担忧限制了术中自体输血（IAT）在泌尿外科手术中的广泛应用。目前尚无关于保护血液免受此类污染的实验报告。为了研究使用自体输血机——血液回收机（Haemonetic Cell Saver）从污染混合物中分离血液，进行了一项包含三个实验的研究。首先，将200毫升血液与200毫升尿液混合，然后用该机器处理混合物，并将浓缩红细胞收集在一个袋子中。对收集到的红细胞溶液（CES）进行生化分析。其次，将200毫升血液与200毫升尿液混合，尿液中调整为每毫升含有10⁷个四种细菌菌株。对CES进行细菌学研究。第三，将200毫升血液与200毫升尿液混合，尿液中调整为含有10⁷个癌细胞。使用了两种细胞系，源自人膀胱癌的KK47和源自人肾细胞癌的ACHN。对CES进行细胞学研究。这些实验的结果是：尿液成分从混合物中被完全去除。然而，尽管细菌数量减少，但所有菌株的细菌都无法被分离。在CES中发现了癌细胞。总之，在泌尿外科手术中，应选择尿液无菌且手术视野中无肿瘤细胞的患者进行IAT。
