Intraoperative autotransfusion

Abstract

Intraoperative autotransfusion was done only sporadically until equipment, modified from cardiac surgery, became available in the 1970's. Use has increased because of the availability of cell‐washing techniques and the increased demand for blood associated with complex operations, such as liver transplantation and resection of thoracoabdominal aneurysms. There is a lack of agreement about the use of anticoagulation with autotransfusion, and there are several factors that limit widespread applicability. More studies are needed regarding infusion of activated clotting factors, and blood contaminated with bacteria or tumor cells. Although a significant administrative commitment is required, implementation of a program of autotransfusion is useful in trauma, vascular surgery, and any procedure that involves large amounts of blood loss.

Salvage autotransfusion versus homologous blood transfusion for ruptured ectopic pregnancy

“…Although a theoretical risk of coagulopathy exists, it has not been born out in practice [2]. The systemic hematologic changes that accompany the autotransfusion of fresh intraperitoneal blood usually revert to normal by the first or second postoperative day [9]. Nevertheless, complications due to extracellular hemoglobin occur when stale hemolyzed blood is re‐infused [10].…”

Intraoperative Blood Salvage: A new Trend in Blood Transfusion Medicine

“…Potential adverse effects of lOBS include sepsis and spread of malignancy. Besides clinical experience several studies support the feasibility of lOBS with patients with contaminated wounds (21)(22)(23) when washing techniques are used and antibiotics added to washing solutions. Nonetheless the risk of sepsis is real since, as shown by Bourdeux (22) cell washing only partially removes blood contamination.…”

Blood Management: Conservation, Salvage, and Alternatives to Allogeneic Transfusion

“…172 Blood salvaged from a serosal cavity has little residual fibrinogen and few platelets, and clotting is usually not a problem; therefore, the addition of anticoagulants to the collection is usually not necessary. 173 Despite the substantial levels of free hemoglobin in the salvaged blood, RBCs survive normally, as documented by studies involving radiolabeled markers. 174 In addition to free hemoglobin, the salvaged blood may be contaminated with tissue exudate, bone, bone marrow, and other biologic and surgical materials; nevertheless, most patients tolerate the infusions well.…”