腎癌手術に試みた自己血輸血の経験

Abstract

1) 1988年1月より1989年4月までの37例の腎癌患者の術中出血量および輸血量の検討より, 腎癌手術の自己血貯血量は600 mlが適当と考えられた.2) 1989年5月より1990年7月の間に15例の腎癌患者に対して自己血輸血による根治的腎摘除術を施行した.5例は輸血なしに, 7例は自己血輸血のみにより手術が行われ, 自己血輸血のほかに同種血輸血を必要としたものは3例であった.3)もどし採血法による貯血式自己輸血法では, 1週間で600 mlの採血が可能であり, 進行例の2症例以外は, 血中ヘモグロビン値の2.0 g/dl以上の変化は見られなかった

We studied the possibility of performing radical nephrectomy with only predeposit autologous blood transfusion in the treatment of patients with renal cell carcinoma. A total of 15 patients who ranged in age from 32 to 69 years and had a hemoglobin concentration of over 12 g/dl on admission underwent radical nephrectomy with preoperative autologous blood donation. Five patients did not need transfusions. Seven patients were transfused only autologous blood. The other 3 required some homologous blood in addition to their own banked blood. In our series, patients were able to donate 600 ml of blood during the last week before surgery and their hemoglobin concentration did not decrease by over 2 g/dl except in the case of two patients with advanced disease. Therefore, it was concluded that an adequate autologous blood volume for nephrectomy was 600 ml and that 80% of renal cell carcinoma surgery could be performed without homologous blood transfusion. For patients requiring resection of renal cell carcinoma, autologous transfusion is recommended as safe and convenient.