The results suggest cell salvage is efficacious in reducing the need for allogeneic red cell transfusion in adult elective cardiac and orthopaedic surgery. The use of cell salvage did not appear to impact adversely on clinical outcomes. However, the methodological quality of trials was poor. As the trials were unblinded and lacked adequate concealment of treatment allocation, transfusion practices may have been influenced by knowledge of the patients' treatment status potentially biasing the results in favour of cell salvage.
Autologous blood transfusion for major vascular surgery using the Sorenson Receptal Device.
Twenty-five patients having aortic surgery had blood scavenged using the Sorenson Receptal Device (Group A) and were compared with twenty-five patients having homologous blood transfusion (Group H). Mean intraoperative blood loss was similar in both groups, Group A 3224 (SD 2392) ml, Group H 2999 (SD 1579) ml, but the mean homologous blood replacement was significantly different intraoperatively, Group A 1.2 (SD 1.7) units, Group H 2.7 (SD 1.8) units. Total intra-hospital homologous blood replacement was not significantly different, Group A 4.0 (SD 3.4) units, Group H 5.5 (SD 5.8) units. Mean haemoglobin concentration in the scavenged blood was 8.5 (SD 2.1) g/dl compared to 10.8 (SD 2.4) g/dl in the median aged homologous blood units crossmatched for Group H. Mean red cell half life in the scavenged blood was the same as that for the homologous blood, 24 (SD 5) days, but plasma-free haemoglobin and bacterial contamination was greater in the scavenged blood. There was no difference in the incidence of postoperative renal dysfunction, coagulopathy or mortality between the two groups of patients.