Clinical practice guidelines for intraoperative cell salvage in patients with malignant tumors
10.13303/j.cjbt.issn.1004-549x.2025.02.001
- VernacularTitle:恶性肿瘤患者术中自体血回输的临床实践指南
- Author:
Changtai ZHU
1
,
2
;
Ling LI
3
;
Zhiqiang LI
1
,
4
;
Xinjian WAN
5
;
Shiyao CHEN
6
;
Jian PAN
7
;
Yi ZHANG
1
;
Xiang REN
1
;
Kun HAN
8
;
Feng ZOU
9
;
Aiqing WEN
10
;
Ruiming RONG
2
,
11
;
Rong XIA
2
,
12
;
Baohua QIAN
2
,
13
;
Xin MA
14
Author Information
1. Department of Blood Transfusion, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
2. Shanghai Medical Association, Transfusion Medicine Branch, Shanghai 200040, China
3. Southwest Jiaotong University Affiliated Hospital, Chengdu Third People's Hospital, Chengdu, Sichuan 610031, China
4. Clinical Transfusion Management Committee, Chinese Society of Blood Transfusion, Beijing 100088, China
5. Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
6. Evidence-Based Medicine Center, Fudan University, Shanghai 200032, China
7. Editorial Department of "Clinical Transfusion and Laboratory Medicine," First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui 230001, China
8. Department of Oncology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
9. Department of Anesthesiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
10. Department of Transfusion Medicine, National Key Laboratory of Trauma and Chemical Poisoning, Daping Hospital, Army Medical University, Chongqing 400042, China
11. Department of Transfusion Medicine, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
12. Department of Transfusion Medicine, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China
13. Department of Transfusion Medicine, First Affiliated Hospital of Navy University, Shanghai 200433, China
14. Department of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
- Publication Type:Journal Article
- Keywords:
intraoperative cell salvage (IOCS);
autologous transfusion;
malignant tumor;
surgery;
guidelines
- From:
Chinese Journal of Blood Transfusion
2025;38(2):149-167
- CountryChina
- Language:Chinese
-
Abstract:
Intraoperative cell salvage (IOCS) has been widely applied as an important blood conservation measure in surgical operations. However, there is currently a lack of clinical practice guidelines for the implementation of IOCS in patients with malignant tumors. This report aims to provide clinicians with recommendations on the use of IOCS in patients with malignant tumors based on the review and assessment of the existed evidence. Data were derived from databases such as PubMed, Embase, the Cochrane Library and Wanfang. The guideline development team formulated recommendations based on the quality of evidence, balance of benefits and harms, patient preferences, and health economic assessments. This study constructed seven major clinical questions. The main conclusions of this guideline are as follows: 1) Compared with no perioperative allogeneic blood transfusion (NPABT), perioperative allogeneic blood transfusion (PABT) leads to a more unfavorable prognosis in cancer patients (Recommended); 2) Compared with the transfusion of allogeneic blood or no transfusion, IOCS does not lead to a more unfavorable prognosis in cancer patients (Recommended); 3) The implementation of IOCS in cancer patients is economically feasible (Recommended); 4) Leukocyte depletion filters (LDF) should be used when implementing IOCS in cancer patients (Strongly Recommended); 5) Irradiation treatment of autologous blood to be reinfused can be used when implementing IOCS in cancer patients (Recommended); 6) A careful assessment of the condition of cancer patients (meeting indications and excluding contraindications) should be conducted before implementing IOCS (Strongly Recommended); 7) Informed consent from cancer patients should be obtained when implementing IOCS, with a thorough pre-assessment of the patient's condition and the likelihood of blood loss, adherence to standardized internally audited management procedures, meeting corresponding conditions, and obtaining corresponding qualifications (Recommended). In brief, current evidence indicates that IOCS can be implemented for some malignant tumor patients who need allogeneic blood transfusion after physician full evaluation, and LDF or irradiation should be used during the implementation process.
