Use of Intraoperative Cell-salvage for Autologous Blood Transfusions in Metastatic Spine Tumour Surgery: A Systematic Review

Metastatic spine tumor surgery (MSTS) and metastatic musculoskeletal tumor surgery (MMTS) are associated with substantial blood loss. Allogeneic blood transfusion is the present method used to replenish this blood. Intraoperative cell salvage (IOCS) is a viable alternative, but is contraindicated in tumor surgery because of the risk of tumor dissemination. Use of IOCS-leucocyte depletion filter (LDF) allows removal of tumour cells from blood salvaged during oncological surgery. However, no reports exist on use of IOCS in MSTS or MMTS. We systematically reviewed studies on IOCS in oncological surgery to investigate whether sufficient evidence exists to support its use in MSTS or MMTS.