scholarly journals Autologous Blood Transfusion for Major Vascular Surgery Using the Sorenson Receptal Device

1987 ◽  
Vol 15 (3) ◽  
pp. 282-288 ◽  
Author(s):  
M. J. Davies ◽  
K. C. Cronin ◽  
P. Moran ◽  
L. Mears ◽  
R. J. Booth
Keyword(s):  
Blood Transfusion ◽  
Aortic Surgery ◽  
Autologous Blood ◽  
Haemoglobin Concentration ◽  
Autologous Blood Transfusion ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
Blood Replacement ◽  
Group A ◽  
Major Vascular Surgery

Twenty-five patients having aortic surgery had blood scavenged using the Sorenson Receptal Device (Group A) and were compared with twenty-five patients having homologous blood transfusion (Group H). Mean intraoperative blood loss was similar in both groups, Group A 3224 (SD 2392) ml, Group H 2999 (SD 1579) ml, but the mean homologous blood replacement was significantly different intraoperatively, Group A 1.2 (SD 1.7) units, Group H 2.7 (SD 1.8) units. Total intra-hospital homologous blood replacement was not significantly different, Group A 4.0 (SD 3.4) units, Group H 5.5 (SD 5.8) units. Mean haemoglobin concentration in the scavenged blood was 8.5 (SD 2.1) g/dl compared to 10.8 (SD 2.4) g/dl in the median aged homologous blood units crossmatched for Group H. Mean red cell half life in the scavenged blood was the same as that for the homologous blood, 24 (SD 5) days, but plasma-free haemoglobin and bacterial contamination was greater in the scavenged blood. There was no difference in the incidence of postoperative renal dysfunction, coagulopathy or mortality between the two groups of patients.

scholarly journals Comparison of the efficacy of autologious blood transfusion combined with preoperative hemodilution, with homologous blood transfusion in patients undergoing elective surgical procedure

2018 ◽  
Vol 5 (3) ◽  
pp. 536
Author(s):  
Sanjay Saksena ◽  
Namrata Jain ◽  
Alok Dixit
Keyword(s):  
Blood Transfusion ◽  
Autologous Blood ◽  
Blood Bank ◽  
Autologous Blood Transfusion ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
Coagulation Profile ◽  
Group A ◽  
Group B ◽  
Transfusion Reactions

Background: To study the changes in haemogram and coagulation profile in patients undergoing autologous and homologous blood transfusion and suitability of the technique of autologous blood transfusion in routine blood bank management.Methods: Patients who were waiting to undergo elective surgical procedures were randomly distributed in two groups, Group A:  Autologous blood transfusion, with or without haemodilution: wherein pre-operative period a predicted volume of blood was collected and Group B: Homologous blood transfusion: where required blood was arranged from Blood Bank. The cardiovascular status, the haemogram and the coagulation profile were recorded at various stages.Results: Out of 240 patients registered only 43 could fulfil the basic requirements only 25 could be motivated in each group. In Group A cases were of age group 51-60 years while it was 41-50 years in Group B. Male:Female ratio was 2:1. 47 Units were retransfused to Group A patients, Group B cases received 45 blood transfusions. In Group A patients 8% cases showed mild hypotention and 1% showed mild hypersensitivity to Haemacel. In Group B, 40% cases showed transfusion reactions. Fall in Hb was lesser in Group A (2.4) on first and (1.7) on second postoperative day compared to Group B (3.3) on first and (2.7) on second postoperative day. The haematocrit levels declined more sharply after operation in Group B (7) rather than Group A (10.4).Conclusions: Advantage of avoiding transfusion reactions, major changes in blood parameters, entry of infections proves Autologous blood transfusion to be the safest, cost effective and easy form of transfusion therapy.

scholarly journals Intraoperative red blood cell salvage and autologous transfusion during open radical retropubic prostatectomy: a cost–benefit analysis

2011 ◽  
Vol 93 (2) ◽  
pp. 157-161 ◽  
Author(s):  
Sarvpreet Ubee ◽  
Manal Kumar ◽  
Nallaswami Athmanathan ◽  
Gurpreet Singh ◽  
Sean Vesey
Keyword(s):  
Blood Transfusion ◽  
Autologous Blood ◽  
Radical Retropubic Prostatectomy ◽  
Autologous Blood Transfusion ◽  
Cell Saver ◽  
Cell Salvage ◽  
Homologous Blood ◽  
Retropubic Prostatectomy ◽  
Group A ◽  
Group B

INTRODUCTION Open radical retropubic prostatectomy (RRP) has an average blood loss of over 1,000ml. This has been reported even from high volume centres of excellence. 1 – 4 We have looked at the clinical and financial benefits of using intraoperative cell salvage (ICS) as a method of reducing the autologous blood transfusion requirements for our RRP patients. MATERIALS AND METHODS Group A comprised 25 consecutive patients who underwent RRP immediately prior to the acquisition of a cell saver machine. Group B consisted of the next 25 consecutive patients undergoing surgery using the Dideco Electa (Sorin Group, Italy) cell saver machine. Blood transfusion costs for both groups were calculated and compared. RESULTS The mean postoperative haemoglobin was similar in both groups (11.1gm/dl in Group A and 11.4gm/dl in Group B). All Group B patients received autologous blood (average 506ml, range: 103–1,023ml). In addition, 5 patients (20%) in Group B received a group total of 16 units (average 0.6 units) of homologous blood. For Group A the total cost of transfusing the 69 units of homologous blood was estimated as £9,315, based on a per blood unit cost of £135. This cost did not include consumables or nursing costs. CONCLUSIONS We found no evidence that autologous transfusions increased the risk of early biochemical relapse or of disease dissemination. ICS reduced our dependence on donated homologous blood.

scholarly journals Should Autologous Blood Transfusion be Rediscovered?

1980 ◽  
Vol 8 (2) ◽  
pp. 168-171 ◽  
Author(s):  
James P. Isbister ◽  
Richard Davis
Keyword(s):  
Blood Transfusion ◽  
Autologous Blood ◽  
Autologous Blood Transfusion ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
Efficient Alternative

With a greater appreciation and understanding of reactions to homologous blood transfusion there has been a renewed interest in autologous blood transfusion. The techniques and indications for preoperative banked autologous blood, perioperative haemodilution and recycled salvaged autologous blood transfusion are described. When circumstances permit, autologous blood transfusion is a safe, economical and efficient alternative to homologous blood.

scholarly journals Haemodilution for Major Vascular Surgery — Using 3.5% Polygeline (Haemaccel)

1982 ◽  
Vol 10 (3) ◽  
pp. 265-270 ◽  
Author(s):  
Michael J. Davies ◽  
Keith D. Cronin ◽  
Charles Domaingue
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Vascular Surgery ◽  
Operative Blood Loss ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
Blood Replacement ◽  
Transfusion Requirements ◽  
Major Vascular Surgery

Intra-operative haemodilution and autotransfusion was carried out in 32 patients having major vascular surgery. The intra-operative blood loss and peri-operative blood replacement was compared with that in 25 patients having similar surgery in whom haemodilution was considered to be contraindicated. Both groups of patients had similar mean intra-operative blood loss measured but homologous blood transfusion requirements were significantly different; 2.6 units (SD 1.9) in the haemodiluted patients compared with 6.0 units (SD 3.5) in the non-diluted patients. There was no mortality in the haemodiluted patients nor was any morbidity attributed to the procedure. Polygeline (haemaccel) was used as the diluent and proved satisfactory for this purpose.

Acute Isovolaemic Haemodilution: The Best Option for Autologous Blood Transfusion in Africa?

1995 ◽  
Vol 25 (4) ◽  
pp. 152-155 ◽  
Author(s):  
Zacharia A Berege ◽  
Bart Jacobs ◽  
Michael R Matasha ◽  
Frank Mpelumbe ◽  
Ernestini Kimaro
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Autologous Blood ◽  
Autologous Blood Transfusion ◽  
Total Blood Volume ◽  
East African ◽  
Homologous Blood ◽  
Total Blood ◽  
Induction Of Anaesthesia ◽  
Donated Blood

The purpose of this study was to identify the best method of autologous blood transfusion to be applied in an East African hospital. One hundred and nine consecutive patients for whom major blood loss was anticipated were enrolled. Seventeen patients donated 1 unit of blood 3 days preoperatively and 92 underwent acute isovolaemic haemodilution prior to induction of anaesthesia. For the haemodiluted patients a 2:1 ratio of sterile pryogen-free saline to collected blood was used. One of the 16 patients from whom 2 units were withdrawn by haemodilution experienced hypovolaemia which was rapidly restored by additional transfusion of colloid. Of the patients who donated blood preoperatively only 23.5% were autotransfused compared to 98.9% of the haemodiluted patients. Of the latter 23.9% (22) had an intraoperative blood loss exceeding 15% of their total blood volume and 7.6% (7) lost more than 25%. Only one received homologous blood in addition. For hospitals with limited blood bank facilities and regular cancellation of surgery, the use of acute isovolaemic haemodilution is recommended. A 3:1 ratio of saline to blood is now advised when 1 unit is withdrawn and a part replacement with crystalloid when 2 units are collected.

These studies indicate that homologous blood transfusion affects the outcome of clinical diseases in both beneficial and adverse ways. Experimental situations are not suitable for randomized clinical trials - transfusions cannot be given to prevent the onset of diabetes or wound strength measured in man following receipt of homologous or autologous blood. These experimental observations indicate that the outcomes of numerous clinical diseases which have not been studied may be manipulated by the use of homologous blood or that transfusion should be avoided. Several studies indicate that changes in immune function following transfusion are permanent. The number of clinical phenomena associated with immune suppression and attributable to blood transfusion is unknown. SUMMARY Given the evidence presented here it would be foolish to suggest that transfusion of homologous blood has no immunologic consequences for the recipient. Blood transfusion is the oldest form of transplant - no one would argue that transplantation between unrelated individuals has no influience on the immune system. In organ transplantation the immunologic sequelae are permanent and there is evidence that the same is true following homologous blood transfusion. Lymphocytopenia is present one year following surgery for Crohn's disease if patients receive perioperative blood transfusion (43). Colorectal cancer patients transfused more than seven years prior to diagnosis have significantly reduced numbers of lymphocytes and lower natural killer cytotoxicity than colorectal cancer patients who have never been transfused (44). Transfusion of neonates causes suppression of lymphocyte reactivity which is still demonstrable 25 to 30 years later (45). There is evidence that transfusion at any time prior to elective surgery increases susceptibility to infectious complications (14) and otherwise healthy transfused individuals may be at increased risk of developing malignancies (46). All the longterm consequences of blood transfusion are not negative: Survival of transplants is prolonged by pretransplant transfusion and some women suffering from recurrent spontaneous abortion can deliver at term if previously transfused with their spouse's leukocytes. In the future we will be able to transfuse blood without causing immune perterbations and the consequent clinical phenomena. Studies presented here suggest that removal of donor leukocytes reduces the risk of infection and cancer recurrence. The technology has not reached the point of reducing the leukocyte number in transfused blood below 10^/unit. An alternative which is increasingly being utilized is autologous blood programs. Physicians are discovering that patients tolerate hemoglobin levels which were previously unacceptably low and many patients prefer being anemic over the risks of receiving homologous blood. Since transfusion is an identifier of high cost hospitalized patients, alternatives to routine blood use are being studied in hopes of safely reducing the costs of transfusion. REFERENCES 1. Jubert AV, Lee ET, Hersh EM, McBride CM. J Surg Res 15:399-403, 1973. 2. M 19 u4n ( s3t ) e3r4A6-M 35 , 2 W , i1n9c8h1u . rch RA, Keane RM, Shatney CH, Ernst CB, Nuidema GD. Ann Surg

1995 ◽  
pp. 300-300
Keyword(s):  
Colorectal Cancer ◽  
Blood Transfusion ◽  
Cancer Patients ◽  
Randomized Clinical Trials ◽  
Elective Surgery ◽  
Autologous Blood ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
One Year ◽  
Colorectal Cancer Patients

scholarly journals The Role of Autologous Blood Transfusion in Joint Replacement Surgery

1995 ◽  
Vol 23 (4) ◽  
pp. 472-477 ◽  
Author(s):  
E. T. Mah ◽  
R. Davis ◽  
P. Seshadri ◽  
T. L. M. Nyman ◽  
R. Seshadri
Keyword(s):  
Blood Transfusion ◽  
Joint Replacement ◽  
Autologous Blood ◽  
Cost Comparison ◽  
Autologous Blood Transfusion ◽  
Homologous Blood Transfusion ◽  
Blood Salvage ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Cost Comparison Analysis

The efficacy of predeposited autologous blood transfusion (PABT) with and without intra/postoperative blood salvage to reduce or eliminate the need for homologous blood transfusion (HBT) in primary total hip or knee replacement surgery was investigated by retrospective and prospective studies. Depending on the type of surgery, one to three units of PABT eliminated the need for HBT in 50 to 78% of patients, but, intra/postoperative blood salvage alone reduced the need only in 11 to 29%. In contrast, blood salvage, when combined with three units of PABT, eliminated the need for HBT in all patients undergoing primary joint replacement surgery. A cost comparison analysis showed that blood salvage was more expensive than PABT, and therefore it should be limited to patients who had predeposited fewer than three units of autologous blood.

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