Postoperative autologous transfusion in cardiac surgery. A prospective, randomised study

Area of Science:

• Cardiovascular Surgery
• Transfusion Medicine
• Biomedical Engineering

Background:

• Coronary artery bypass surgery (CABG) often necessitates homologous blood transfusions.
• Reducing allogeneic blood exposure is crucial for patient safety and resource management.

Purpose of the Study:

• To evaluate the safety and efficacy of postoperative autologous blood transfusion (AT) using the Shiley hardshell venous reservoir.
• To determine the impact of AT on homologous blood requirements in CABG patients.

Main Methods:

• A prospective, randomized, controlled study involving 40 patients undergoing elective CABG.
• Two matched groups: one receiving AT with the Shiley hardshell venous reservoir, and a control group.
• Monitoring of shed mediastinal blood reinfused, homologous blood usage, clinical outcomes, and laboratory parameters.

Main Results:

• AT significantly reduced homologous blood use by 38.7% (p < 0.05).
• Reinfused mediastinal blood was well-oxygenated and contained significant levels of hemoglobin and platelets.
• No statistically significant differences in clinical outcomes, overall blood loss, or organ function were observed between groups.
• A minor reduction in fibrinogen levels was noted in the AT group (p < 0.05).
• No instances of bacteremia or AT-related infections were reported.

Conclusions:

• Postoperative autologous transfusion with the Shiley hardshell venous reservoir is a safe and effective method.
• This technique significantly decreases the need for homologous blood in CABG procedures.
• AT offers a viable alternative to allogeneic transfusions, improving patient outcomes and conserving blood resources.