Intraoperative autotransfusion in major vascular surgery

Autologous blood transfusion in dogs with thoracic or abdominal hemorrhage: 25 cases (2007–2012)

“…ABT has been described extensively in the human literature with few complications reported . Reported advantages of ABT when compared to allogeneic blood transfusion include immediate availability, blood compatibility, avoidance of transfusion reactions, normothermic transfusion, no transmission of infectious agents, higher levels of RBC 2,3‐diphosphoglycerate, and decreased overall cost .…”

“…It is unknown whether administering an ABT obtained from the hemorrhage of a ruptured tumor could contribute meaningfully to metastatic cancer spread in dogs. Some authors state that ABT is contraindicated in cases of neoplastic disease . However, investigations in people have failed to demonstrate worse outcome or increased metastatic rate associated with administration of ABT to patients undergoing oncological surgery, and no association has been found between the presence of circulating neoplastic cells and poorer prognosis .…”

“…Well‐described techniques for ABT in companion animals were used in this study, and differed from the ABT technique described using a cell saver device . Recommendations to minimize lysis of ABT RBCs during collection include minimizing aspiration of air or mixing of the collected blood with air; keeping the vacuum suction tip below the surface of the blood pool to decrease the blood‐air interface; and maintaining an ideal vacuum pressure between 40 and 60 mm Hg, and always below 100 mmHg …”

“…The final 2 dogs with hemolytic serum color died as a result of uncontrollable traumatic hemorrhage, with hemolysis not likely a contributing factor. Monitoring for hemolysis post‐ABT is recommended …”

“…In previous reports, small increases in PT and PTT were noted but self‐corrected within 72 hours of ABT . Dilutional coagulopathy in people has been reported when transfusion volume exceeds 3,500 mL . There are guidelines for plasma administration for people receiving ABT, with the recommendation that either 1 unit of fresh frozen plasma be given for every 2 units of ABT administered, or that plasma be administered to effect when the ABT volume exceeds 3500 mL .…”