Abstract
An understanding of how to safely apply intraoperative blood salvage (IBS) in cancer surgery has not yet been obtained. Here, we investigated the optimal dose of 137Cs gamma-ray irradiation for killing human hepatocarcinoma (HepG2), gastrocarcinoma (SGC7901), and colonic carcinoma (SW620) tumor cells while preserving co-cultured erythrocytes obtained from 14 healthy adult volunteers. HepG2, SGC7901, or SW620 cells were mixed into the aliquots of erythrocytes. After the mixed cells were treated with 137Cs gamma-ray irradiation (30, 50, and 100 Gy), tumor cells and erythrocytes were separated by density gradient centrifugation in Percoll with a density of 1.063 g/ml. The viability, clonogenicity, DNA synthesis, tumorigenicity, and apoptosis of the tumor cells were determined by MTT assay, plate colony formation, 5-ethynyl-2'-deoxyuridine (EdU) incorporation, subcutaneous xenograft implantation into immunocompromised mice, and annexin V/7-AAD staining, respectively. The ATP concentration, 2,3-DPG level, free Hb concentration, osmotic fragility, membrane phosphatidylserine externalization, blood gas variables, reactive oxygen species levels, and superoxide dismutase levels in erythrocytes were analyzed. We found that 137Cs gamma-ray irradiation at 50 Gy effectively inhibited the viability, proliferation, and tumorigenicity of HepG2, SGC7901, and SW620 cells without markedly damaging the oxygen-carrying ability or membrane integrity or increasing the oxidative stress of erythrocytes in vitro. These results demonstrated that 50 Gy irradiation in a standard 137Cs blood irradiator might be a safe and effective method of inactivating HepG2, SGC7901, and SW620 cells mixed with erythrocytes, which might help to safely allow IBS in cancer surgery.
Highlights
Oncologic surgery is often accompanied by massive blood loss that requires blood transfusion [1]
After 137Cs gammaray irradiation (0, 30, 50 and 100 Gy), HepG2 (A), SW620 (B), and SGC7901 (C) cells separated from human erythrocytes were cultured for 24 h, (D) 48 h and 72 h, and the viability was detected by MTT assay
Gastrointestinal cancer surgery is associated with a high likelihood of allogeneic blood transfusion, which produces many complications [27]
Summary
Oncologic surgery is often accompanied by massive blood loss that requires blood transfusion [1]. Allogeneic blood transfusion (ABT) is often used to replenish blood lost during tumor. ABT in oncological surgery is associated with many complications, such as postoperative infection, pulmonary complications, poor outcomes, and even the promotion of tumor recurrence [1]. To minimize or prevent the complications of ABT, intraoperative blood salvage (IBS) was recently developed. This technique involves the suction, collection, filtration, and washing of blood from the surgical field before reinfusion with erythrocytes. The technique has been widely used in a variety of surgeries and very effectively saves blood and reduces ABT-related complications [2]
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