[An experience of intraoperative blood salvage in emergency laparotomy for severe abdominal injury]

A 34-year-old male patient, who had fallen from a balcony suffering liver injury, underwent emergency laparotomy for right liver lobectomy and portal vein repair. For the first two hours of operation, the blood loss exceeded 12,000 ml, and his hemoglobin level dropped to 2.6 g x dl(-1) despite administration of 30 units of packed red cells (MAP). At this point, no more MAP was available in our hospital. Then we decided to initiate intraoperative blood salvage in order to minimize the further loss of hemoglobin. For 26,200 ml of the total blood loss, 1160 ml of packed red cells were restored from 7600 ml of salvaged blood, and 46 units of MAP, 40 units of fresh frozen plasma and 20 units of platelets were administered. His postoperative course was not complicated by systemic infection. Although intraoperative blood salvage is proved to be useful for reducing allogenic transfusion, it is not recommended to be used in surgery for trauma because of a potential risk of serious systemic infection. Our experience, however, suggests that intraoperative blood salvage could be utilized as a life-saving means even in trauma surgery.