{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T07:33:03Z","timestamp":1788852783249,"version":"build-2803163510"},"reference-count":55,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,6,10]],"date-time":"2018-06-10T00:00:00Z","timestamp":1528588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To evaluate systematically the safety and efficacy of intra\u2010operative cell salvage (\n                      <jats:styled-content style=\"fixed-case\">ICS<\/jats:styled-content>\n                      ) in urology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A search of Medline, Embase and Cochrane Library to August 2017 was performed using methods pre\u2010published on\n                      <jats:styled-content style=\"fixed-case\">PROSPERO<\/jats:styled-content>\n                      . Reporting followed the Preferred Reporting Items for Systematic Review and Meta\u2010analysis guidelines. Eligible titles were comparative studies published in English that used\n                      <jats:styled-content style=\"fixed-case\">ICS<\/jats:styled-content>\n                      in urology. Primary outcomes were allogeneic transfusion rates (\n                      <jats:styled-content style=\"fixed-case\">ATR<\/jats:styled-content>\n                      s) and tumour recurrence. Secondary outcomes were complications and cost.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fourteen observational studies were identified, with a total of 4 536 patients.\n                      <jats:styled-content style=\"fixed-case\">ICS<\/jats:styled-content>\n                      was compared with no the blood conservation technique (seven studies), preoperative autologous donation (\n                      <jats:styled-content style=\"fixed-case\">PAD<\/jats:styled-content>\n                      ; five studies) or both (two studies). Cohorts underwent open prostatectomy (11 studies), open cystectomy (two studies) or open partial nephrectomy (one study). Meta\u2010analysis was possible only for\n                      <jats:styled-content style=\"fixed-case\">ATR<\/jats:styled-content>\n                      s within prostatectomy studies. In this setting,\n                      <jats:styled-content style=\"fixed-case\">ICS<\/jats:styled-content>\n                      reduced\n                      <jats:styled-content style=\"fixed-case\">ATR<\/jats:styled-content>\n                      compared with no the blood conservation technique (odds ratio [\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      ] 0.34, 95% confidence interval [\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ] 0.15\u20130.76) but not\n                      <jats:styled-content style=\"fixed-case\">PAD<\/jats:styled-content>\n                      (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      0.76, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.39\u20131.31). In the non\u2010prostatectomy setting,\n                      <jats:styled-content style=\"fixed-case\">ATR<\/jats:styled-content>\n                      s amongst patients who underwent\n                      <jats:styled-content style=\"fixed-case\">ICS<\/jats:styled-content>\n                      were significantly higher or similar in one and two studies, respectively. Tumour recurrence was found to be significantly less common (two studies), similar (eight studies) or not measured (four studies). All six studies reporting complications found no difference in their\n                      <jats:styled-content style=\"fixed-case\">ICS<\/jats:styled-content>\n                      cohorts. Regarding cost, one study from 1995 found\n                      <jats:styled-content style=\"fixed-case\">ICS<\/jats:styled-content>\n                      more expensive than\n                      <jats:styled-content style=\"fixed-case\">PAD<\/jats:styled-content>\n                      , while two more recent studies found\n                      <jats:styled-content style=\"fixed-case\">ICS<\/jats:styled-content>\n                      to be cheaper than no blood conservation technique. As a result of inter\u2010study heterogeneity, meta\u2010analyses were not possible for recurrence, complications or cost.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Low\u2010level evidence exists that, compared with other blood conservation techniques,\n                      <jats:styled-content style=\"fixed-case\">ICS<\/jats:styled-content>\n                      reduces\n                      <jats:styled-content style=\"fixed-case\">ATR<\/jats:styled-content>\n                      and cost while not affecting complications. It does not appear to increase tumour recurrence post\u2010prostatectomy, although follow\u2010up durations were short. Small study sizes and short follow\u2010ups mean conclusions cannot be drawn with regard to recurrence after nephrectomy or cystectomy. Randomized trials with long\u2010term follow\u2010up evaluating\n                      <jats:styled-content style=\"fixed-case\">ICS<\/jats:styled-content>\n                      in urology are required.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.14373","type":"journal-article","created":{"date-parts":[[2018,5,4]],"date-time":"2018-05-04T00:01:48Z","timestamp":1525392108000},"page":"210-219","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Intra\u2010operative cell salvage in urological surgery: a systematic review and meta\u2010analysis of comparative studies"],"prefix":"10.1111","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7833-2537","authenticated-orcid":false,"given":"Ned","family":"Kinnear","sequence":"first","affiliation":[{"name":"Department of Urology Austin Health Melbourne Vic. 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