Torre G C, Ferrari M, Favre A, Razzetta F, Borgonovo G
Istituto di Clinica Chirurgica, University of Genoa, Italy.
Eur J Surg Oncol. 1994 Oct;20(5):565-70.
Homologous blood transfusion in the cancer patient is dangerous because of an apparent immunodepressive action. Even a program of pre-deposit and isovolemic hemodilution, for reasons of immediacy and patient conditions, is often not feasible. Likewise, the intraoperative recovery of blood, although used by some, does not prevent the possible reinfusion of suspended neoplastic cells. A system that eliminates tumor cells could enable the recovery of blood in cancer patients in non-septic operative sites. A system that seems to correspond to these requisites has been set up by inserting two filters for the elimination of leucocytes from erythrocyte concentrates into a cell separator that is normally used in clinical practice. Laboratory studies, using immunohistochemical identification of tumor cells cultivated in vitro, have demonstrated the absence of contaminating cells in blood available for reinfusion.
癌症患者进行同源输血很危险,因为其具有明显的免疫抑制作用。即便出于紧迫性和患者自身状况的考虑,采用术前预存自体血和等容血液稀释的方案,通常也不可行。同样,术中血液回收虽然被一些人采用,但并不能防止可能重新输入悬浮的肿瘤细胞。一个能清除肿瘤细胞的系统可以使在非感染性手术部位的癌症患者回收自身血液。通过将两个用于从浓缩红细胞中清除白细胞的过滤器插入临床实践中常用的细胞分离器,建立了一个似乎符合这些要求的系统。利用体外培养肿瘤细胞的免疫组化鉴定进行的实验室研究表明,可供重新输入的血液中不存在污染细胞。