Evaluation of Autologous Shed Blood for Autotransfusion After Orthopaedic Surgery

Healy, William L.; Pfeifer, Bernard A.; Kurtz, S. R.; Johnson, Charles L.; Johnson, William W.; Johnston, Renner; Sanders, David; Karpman, Robert R.; Hallack, George N.; Valeri, C. R.

doi:10.1097/00003086-199402000-00007

Cited by 43 publications

(40 citation statements)

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“…This observation confirms the view that no anticoagulant is needed in the container ( Faris et al 1991, Healy et al 1994. In the drain blood there was also seen a rise in FDP that relates to the consumption of fibrinogen.…”

Section: Discussionsupporting

confidence: 83%

“…The absence of adverse reactions accords with the findings of others (Bengtson et al 1990, Kristensen et al 1992, Blevins et al 1993, Healy et al 1994, although some authors have reported clinical complications between 2 and 25 percent of their patients within 6 hours after reinfusion (Faris et al 1991, Clements et al 1992, Martin et al 1992. Because of reported complications, some authors have recommended that the drain blood be washed prior to retransfusion.…”

Section: Discussionsupporting

confidence: 82%

See 1 more Smart Citation

Cell quality of salvaged blood after total knee arthroplasty:Drain blood compared to venous blood in 32 patients

Dalén

Broström

1995

Acta Orthopaedica Scandinavica

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 82%

Cell quality of salvaged blood after total knee arthroplasty:Drain blood compared to venous blood in 32 patients

Dalén

Broström

1995

Acta Orthopaedica Scandinavica

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“…Moreover, as in other studies in knee, hip or spine surgery [2,3,5,6,11,13,14,15,30,32] and cardiac surgery [1,7,28], postoperative reinfusion of unwashed filtered shed blood after major spine procedures has proved to reduce homologous transfusion requirements, with only minor complications. A prospective study, using the Constavac CBC II plus short-time preoperative autologous blood predeposit, is currently in progress to evaluate the impact of this strategy, not only on the prevalence of homologous blood transfusion but also on the haemostatic and immunological status of the patients.…”

Section: Discussionmentioning

confidence: 67%

“…However, although the safety of reinfusion of unwashed shed blood after orthopaedic [2,3,5,11,12,13,14,15,20,30] operations is well documented, the controversy about its effectiveness still exists regarding the functionality and viability of the reinfused erythrocytes, the nephrotoxic effects of free haemoglobin, the alteration of the immune response and the alteration of the haemostasia [5,21]. Accordingly, this study was initiated:…”

Section: Introductionmentioning

confidence: 99%

Postoperative blood salvage and reinfusion in spinal surgery: blood quality, effectiveness and impact on patient blood parameters

Sebastian¹,

Romero²,

Olalla³

et al. 2000

European Spine Journal

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IntroductionThe development of complex surgical procedures for the treatment of orthopaedic diseases and the increasing number of traffic accidents have raised the demand for allogenic blood to a level that often exceeds supply. In addition, the increased awareness of the potential hazards of allogenic blood transfusion, such as incompatibility reactions, metabolic and immunological disorders or transmission of viral diseases, has led to an emphasis on blood saving techniques [10,18,25].Abstract Although reinfusion of salvaged shed blood has become popular in major orthopaedic procedures, this blood saving technique is still controversial. In an effort to assess the functional and metabolic status of shed blood erythrocytes and the impact of postoperative shed blood reinfusion on allogenic blood requirements and patient's blood parameters, analyses of perioperative blood samples were performed in 28 consecutive orthopaedic patients undergoing spinal fusion, in which postoperative shed blood was collected and reinfused with the ConstaVac CBC II device. In comparison with a previous series of 31 patients, this procedure reduced allogenic blood requirements by almost 30% (P < 0.05), without any increase in postoperative complications. Postoperative shed blood presented lower haematological values and higher plasma-free haemoglobin (PFHB) levels than preoperative blood, without any disturbance in morphology, median corpuscular fragility (MCF) or erythrocyte adenosine triphosphate (ATP) and diphosphoglycerate (DPG) content. Serum concentrations of enzymes -glutamate-oxalacetate aminotransferase (GOT), glutamate-piruvate aminotransferase (GPT), creatine kinase (CK), lactate dehydrogenase (LDH) -and inflammatory cytokines (IL-1β, IL-6) were elevated in shed blood. After reinfusion, there was no alteration in coagulation parameters or cytokine levels. Serum levels of some enzymes increased at the end of surgery and remained elevated at postoperative day 2 (CK) or 7 (GOT, LDH), with a higher increase if postoperative autotransfusion was used as a blood saving method. Therefore, caution should be taken when these serum enzyme levels are used for diagnosis. In conclusion, salvaged shed blood in orthopaedic procedures of the spine seems to be an excellent source of red cells which are not significantly damaged, keeping a normal functional and metabolic status, and reduces allogenic blood requirements without significant side effects.

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“…Most studies evaluating blood loss and blood transfusion in patients undergoing spine surgery have been limited by small sample size or have been conducted in the pediatric population [7,9,11,14,18,22,25]. Published studies of total joint arthroplasty have outlined possible differences in postoperative complications for patients who predonated autologous blood compared with patients who received washed cell-saver blood during surgery [4,17,24].…”

Section: Introductionmentioning

confidence: 99%

Allogeneic Transfusion after Predonation of Blood for Elective Spine Surgery

Brookfield

Brown

Henriques

et al. 2008

Clin Orthop Relat Res

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The literature suggests preoperative autologous blood donation in total joint arthroplasty is associated with increased overall transfusion rates compared with nondonation and is not cost-effective for all patients. We asked whether the amount of intraoperative blood loss and blood replacement differs between autologous donors and nondonors in elective spine surgery and whether the rates of allogeneic blood transfusions differ between the two groups; we then determined the cost of wasted predonated units. We retrospectively reviewed 676 patients who underwent elective lumbar spine surgery and compared relevant data to that in a matched cohort of 51 patients who predonated blood and 51 patients who received only cellsaver blood and underwent instrumented spinal fusion.

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Evaluation of Autologous Shed Blood for Autotransfusion After Orthopaedic Surgery

Cited by 43 publications

References 0 publications

Cell quality of salvaged blood after total knee arthroplasty:Drain blood compared to venous blood in 32 patients

Cell quality of salvaged blood after total knee arthroplasty:Drain blood compared to venous blood in 32 patients

Postoperative blood salvage and reinfusion in spinal surgery: blood quality, effectiveness and impact on patient blood parameters

Allogeneic Transfusion after Predonation of Blood for Elective Spine Surgery

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