The role of intraoperative cell salvage system on blood management in major orthopedic surgeries: a cost–benefit analysis

Duramaz, Altuğ; Bilgili, Mustafa Gökhan; Bayram, Berhan; Ziroğlu, Nezih; Edipoğlu, Erdem; Öneş, Halil Nadir; Kural, Cemal; Avkan, Mustafa Cevdet

doi:10.1007/s00590-017-2098-2

Cited by 11 publications

(14 citation statements)

References 21 publications

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“…Transfusions above 6 units have an impact on survival and retransplantation rates[5]. Although some authors question the real impact of transfusing small volumes of allogeneic blood on surgical outcomes, there is a consensus on the negative effects of massive transfusion[6,7].…”

Section: Intraoperative Bleeding Managementmentioning

confidence: 99%

“…Transfusion of blood components during LT is a predictive factor for postoperative mortality and tumor recurrence, by mechanisms not yet completely elucidated[10]. In addition, it poses risks such as bacterial infections, anaphylaxis, hemolytic reactions, transfusion-related acute lung injury, and viral infections[6]. Another negative effect of allogeneic transfusion, observed in kidney transplant recipients, is the potential for increased rates of acute cellular rejection due to alloimmunization to the antigens present in the transfused blood[13,14].…”

Section: Harmful Effects Of Allogeneic Transfusionmentioning

confidence: 99%

“…Another negative effect of allogeneic transfusion, observed in kidney transplant recipients, is the potential for increased rates of acute cellular rejection due to alloimmunization to the antigens present in the transfused blood[13,14]. In addition to the risks of blood transfusion, it should be noted that allogeneic blood has a lower oxygen-carrying capacity than autologous blood[6,15].…”

Section: Harmful Effects Of Allogeneic Transfusionmentioning

confidence: 99%

“…Approximately 70% of the blood collected can be reinfused[6]. A crucial step is the clearance of free hemoglobin from the reinfused blood, because this molecule can promote pulmonary, renal, and platelet dysfunction[28].…”

Section: Ibsa Devicesmentioning

confidence: 99%

“…However, no consensus has been reached on the use of IBSA in LT[7]. Some studies have not identified the above-mentioned potential advantages[6,31,44], and cost-effectiveness has also been questioned[7].…”

Section: Advantages Of Ibsamentioning

confidence: 99%

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Intraoperative cell salvage with autologous transfusion in liver transplantation

Pinto

Chedid

Sekine

et al. 2019

WJGS

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Liver transplant (LT) is the primary treatment for patients with end-stage liver disease. About 25000 LTs are performed annually in the world. The potential for intraoperative bleeding is quite variable. However, massive bleeding is common and requires blood transfusion. Allogeneic blood transfusion has an immunosuppressive effect and an impact on recipient survival, in addition to the risk of transmission of viral infections and transfusion errors, among others. Techniques to prevent excessive bleeding or to use autologous blood have been proposed to minimize the negative effects of allogeneic blood transfusion. Intraoperative reinfusion of autologous blood is possible through previous self-donation or blood collected during the operation. However, LT does not normally allow autologous transfusion by prior self-donation. Hence, using autologous blood collected intraoperatively is the most feasible option. The use of intraoperative blood salvage autotransfusion (IBSA) minimizes the perioperative use of allogeneic blood, preventing negative transfusion effects without negatively impacting other clinical outcomes. The use of IBSA in patients with cancer is still a matter of debate due to the theoretical risk of reinfusion of tumor cells. However, studies have demonstrated the safety of IBSA in several surgical procedures, including LT for hepatocellular carcinoma. Considering the literature available to date, we can state that IBSA should be routinely used in LT, both in patients with cancer and in patients with benign diseases.

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Section: Intraoperative Bleeding Managementmentioning

confidence: 99%

Section: Harmful Effects Of Allogeneic Transfusionmentioning

confidence: 99%

Section: Harmful Effects Of Allogeneic Transfusionmentioning

confidence: 99%

Section: Ibsa Devicesmentioning

confidence: 99%

Section: Advantages Of Ibsamentioning

confidence: 99%

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Intraoperative cell salvage with autologous transfusion in liver transplantation

Pinto

Chedid

Sekine

et al. 2019

WJGS

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Cell salvage for minimising perioperative allogeneic blood transfusion in adults undergoing elective surgery

Lloyd,

Geneen,

Bernhardt

et al. 2023

Cochrane Database of Systematic Reviews

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Contribution of Salvaged Blood Red Blood Cell Transfusion During Living Donor Liver Transplantation

et al. 2023

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Background Transfusion of allogeneic blood products can have adverse effects and profoundly influence postoperative liver transplantation outcomes, including graft survival. To minimize allogeneic red blood cell (RBC) transfusion, salvaged blood can be used during liver transplantation. The aim of this study was to determine the contribution of salvaged blood to allogeneic RBC transfusion in living donor liver transplantation (LDLT) recipients. Methods Data of 311 adult‐to‐adult LDLT recipients between January 2015 and April 2019 were analyzed. The primary outcome was a change in requirement for allogeneic RBCs due to the use of salvaged blood. Additionally, predictors of intraoperative allogeneic RBC transfusion were investigated. Results One hundred fifty‐three (49.2%) recipients required allogeneic RBC transfusion. If recipients did not receive salvaged blood, 253 (81.4%) recipients would have needed allogeneic RBC transfusion. The total volume of salvaged blood transfused into recipients during surgery was 269,165 mL, which corresponded to 993 units of allogeneic RBCs and accounted for 76.1% of total RBC transfusion volume. Multivariate analysis showed that male recipients, model for end‐stage liver disease score, preoperative hemoglobin level, and volume of salvaged blood used during surgery were independent predictors of the need for intraoperative allogenic RBC transfusion. Conclusions Intraoperative use of salvaged blood significantly reduced allogeneic RBC transfusion in LDLT recipients. It can help transplant teams manage transfusion of allogeneic RBCs during liver transplantation.

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The role of intraoperative cell salvage system on blood management in major orthopedic surgeries: a cost–benefit analysis

Abstract: Although CS usage was determined to increase the costs in this study, it significantly decreases intraoperative and postoperative ABT requirements. We believe that the increase in cost may be neglected when the complications and prolonged hospitalization due to ABT usage were regarded.

Cited by 11 publications

References 21 publications

Intraoperative cell salvage with autologous transfusion in liver transplantation

Intraoperative cell salvage with autologous transfusion in liver transplantation

Cell salvage for minimising perioperative allogeneic blood transfusion in adults undergoing elective surgery

Contribution of Salvaged Blood Red Blood Cell Transfusion During Living Donor Liver Transplantation

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