Related Experiment Video
Updated: Jun 5, 2026
A Genetically Engineered Mouse Model of Sporadic Colorectal Cancer
Published on: July 6, 2017
Cross-matched blood in colorectal surgery: a clinical waste?
H Shaker1, M Wijesinghe, A Farooq
1Department of Surgery, Southport & Ormskirk Hospital, Southport, Merseyside, UK. hud@doctors.org.uk
Insights
Few patients need blood transfusions during elective colorectal surgery. Routine cross-matching is unnecessary for patients eligible for electronic issue (EI), optimizing blood resource management.
Area of Science:
- Transfusion Medicine
- Colorectal Surgery
- Evidence-Based Practice
Background:
- Perioperative blood transfusion is a common practice in major colorectal surgery.
- Optimizing blood usage and reducing wastage are critical in transfusion medicine.
- Establishing evidence-based guidelines for blood requests can improve efficiency.
Purpose of the Study:
- To determine the rate of perioperative blood transfusion in elective colorectal surgery.
- To develop an evidence-based approach for requesting blood products.
- To evaluate the utility of electronic issue (EI) for blood products.
Main Methods:
- A comparative cohort study of 164 patients undergoing major colorectal surgery.
- Data collected included demographics, operative details, blood cross-matched, and units transfused.
- Calculated cross-match to transfusion (C:T) ratio and assessed patient suitability for EI.
Main Results:
- Only 13% of patients received transfusions (48 units total).
- The overall cross-match to transfusion ratio was 3.4:1.
- Most patients (78%) were suitable for electronic issue, and transfusions were often non-urgent.
Conclusions:
- A small proportion of patients require perioperative transfusions in elective colorectal surgery.
- Routine cross-matching is not indicated for patients suitable for electronic issue.
- Implementing EI can enhance the efficiency of blood product management.
Aim:
This study was carried out to determine the rate of perioperative blood transfusion and to create an evidence-based approach to requesting blood for elective colorectal surgery.
Method:
A comparative cohort study was carried out of 164 patients (107 men, 57 women, median age 68 years) who underwent major colorectal surgery. Details obtained included demographic and operative information, the number of units of blood cross-matched, units used, the reasons for transfusion and patient suitability for electronic issue (EI). The cross-match to transfusion ratio (C:T ratio) was calculated for each procedure and for the whole group of colorectal procedures.
Results:
Some 162 units of blood were cross-matched for 76 (46%) patients, with the remaining 88 (54%) being grouped with serum saved. Twenty-one (13%) were transfused with a total of 48 units of blood. The C:T ratio for all procedures was 3.4/1. The commonest indication for transfusion was anaemia. One patient required an emergency transfusion. The majority (78%) of patients were suitable for EI. There were no significant differences between the transfused and nontransfused groups with regard to age, diagnosis (malignant vs benign) and laparoscopic or open colorectal procedure.
Conclusion:
Only a small proportion of patients undergoing elective major colorectal surgery require perioperative blood transfusions, most of which are nonurgent. Blood should not be routinely cross-matched in patients who are suitable for EI.
