Intraoperative autotransfusion during abdominal aortic reconstruction

Area of Science:

• Cardiovascular Surgery
• Transfusion Medicine
• Nephrology

Background:

• Intraoperative autotransfusion (IAT) is a critical component of managing blood loss in major surgeries.
• Continuous-flow centrifugation systems offer a method for processing salvaged blood during procedures.

Purpose of the Study:

• To prospectively evaluate the safety and efficacy of IAT using a continuous-flow centrifuge system in abdominal aortic reconstructions.
• To compare the quality and patient outcomes of autotransfused blood versus homologous bank blood.

Main Methods:

• Prospective study of 50 consecutive patients undergoing abdominal aortic reconstruction with IAT.
• Tabulation of blood loss, salvaged volume, and transfused volumes.
• Comparison of autotransfused blood and bank blood for oxygen-carrying capacity, coagulation factors, microaggregates, pH, and free hemoglobin.
• Chromium-51 red cell survival studies and assessment of renal, hepatic, and coagulation function postoperatively.

Main Results:

• Patients received a mean of 1,203 ml autotransfused blood and 1,682 ml bank blood for an average blood loss of 2,386 ml.
• Autotransfused blood demonstrated superior oxygen-carrying capacity, lower microaggregate levels, and better buffering capacity than bank blood.
• Red blood cell survival was comparable between salvaged autologous blood and unshed autologous blood.
• No clinically significant aberrations in coagulation, hepatic, or renal function were observed, despite transient elevations in liver function and free hemoglobin.

Conclusions:

• Continuous-flow centrifuge IAT is a safe and effective method for abdominal aortic reconstruction.
• Salvaged autologous blood processed via this system is of high quality and comparable to bank blood in terms of red cell survival.
• IAT does not lead to clinically important adverse effects on renal, hepatic, or coagulation systems.