Department of General Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China.
World J Gastroenterol. 2013 Jun 14;19(22):3371-4. doi: 10.3748/wjg.v19.i22.3371.
Intraoperative blood salvage autotransfusion (IBSA) is used in various surgical procedures. However, because of the risk of reinfusion of salvaged blood contaminated by tumor cells, the use of IBSA in hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT) is controversial. The critical points include whether tumor cells can be cleared by IBSA, whether IBSA increases the risk of recurrence or metastasis, and what are the indications for IBSA. Moreover, is it warranted to take the risk of tumor dissemination by using IBSA to avoid allogeneic blood transfusion? Do the remaining tumor cells after additional filtration by leukocyte depletion filters still possess potential tumorigenicity? Does IBSA always work well? We have reviewed the literature and tried to address these questions. The available data indicate that IBSA is safe in LT for HCC, but randomized, controlled and prospective trials are urgently required to clarify the uncertainty.
术中回收式自体输血（IBSA）在各种外科手术中得到了广泛应用。然而，由于回收的血液存在被肿瘤细胞污染的风险，因此在接受肝移植（LT）的肝细胞癌（HCC）患者中使用 IBSA 存在争议。关键问题包括 IBSA 是否可以清除肿瘤细胞，IBSA 是否会增加复发或转移的风险，以及 IBSA 的适应证是什么。此外，是否值得冒着肿瘤播散的风险使用 IBSA 来避免异体输血？经过白细胞滤器进一步过滤后残留的肿瘤细胞是否仍具有潜在的致瘤性？IBSA 是否总是有效？我们已经查阅了文献，并试图回答这些问题。现有数据表明，IBSA 在 HCC 的 LT 中是安全的，但迫切需要进行随机、对照和前瞻性试验来阐明不确定性。
