Risks of Blood Transfusion
The Serious Hazards of Transfusion (SHOT) annual report 2007 concludes that the greatest risk in transfusion of blood products is the risk of the patient receiving the wrong blood. Ref http://www.shotuk.org/home.htm
Please click here for full statistics and the procedures that ICS can be used in.
The Advantages of Autologous Transfusion
Benefits of Cell Salvage
- Avoidance of the greatest risk of transfusion – wrong blood to wrong patient and also that of transfusion-transmitted diseases 1, 2, 3
- High quality, fully functional red cells reinfused. Normal levels of 2,3 DPG mean that tissue perfusion is good. Stored packed red cells contain no 2,3 DPG and patient levels will not return to normal for approx. 24 hours when donor blood is given.
- Haemolysed red cells are removed by washing (as is the extracellular potassium released from the cells) but when using donor (or unwashed) blood these are infused to the patient.
- Reduction of infection (suppression of immune system) 1
- 44.4% postoperative infection rate with allogeneic (donor) blood vs. 17.4% with autologous (patient’s own) blood 2
32% with homologous transfusion vs. 3% with autologous transfusion 4 - Shorter hospital stay
- 12 days vs. 9 days for patients having AAA surgery 2
- 3.2 extra days in hospital if infections occur 4
- Reduced cost of antibiotics and laboratory tests 2,4,5
- 7.6 extra days of antibiotic therapy
- Reduction of allogeneic transfusion (mean 3.8 units for revision hips) 6
By reducing the length of hospital stay, cell salvage can have a very positive impact on available beds during those times of the year when beds are at a premium. Shorter hospital stay and reduced complications, thereby requiring less staff attention, increases the efficient use of expensive in-patient beds.
Complications occurring when donor blood is used are well documented. All hospitals are required to submit reports of complications and incidences to the MHRA via the SABRE system and voluntarily to SHOT.
References:
1. Mercer KG, Spark JI, Berridge DC, Kent PJ, Scott DJA; Leeds
Randomized clinical trial of intraoperative autotransfusion in surgery for abdominal aortic aneurysm Brit J of Surg 2004 Nov;91(11):1443-1448
2. Spark JI, Chetter IC, Kester RC, Scott DJ, St.James Hosp, Leeds - Allogeneic vs. autologous blood during abdominal aortic aneurysm surgery.
Eur J Vasc Endovasc Surg, 1997
3. SHOT report 2006 Published 20th November, 2007 by The Serious Hazards of Transfusion Steering Group Chair: Dr Hannah Cohen. http://www.shotuk.org/SHOT%20Report%202007.pdf
4. Murphy; J.M. Heal; N. Blumberg; Rochester Medical Center, NY
Infection or suspected infection after hip replacement surgery with autologous or homologous blood transfusions Transfusion March1991
5. Glenngård AH et al, Costs associated with blood transfusions in Sweden – the societal cost of autologous, allogeneic and perioperative RBC transfusion Transfusion Medicine, 2005, 15, 295-306
6. Bridgens J.P., Evans C.R., Dobson P.M.S. and Hamer A.J.; Sheffield, England – Intraoperative Red Cell Salvage in Revision Hip Surgery. The Journal of Bone and Joint Surgery vol. 89-A – NUMBER 2 February 2007
