Clinical Utility of Autologous Salvaged Blood: a Review

Journal of Gastrointestinal Surgery

Volumn 24, Issue 2, 2020, Pages 464-472

  Frank, Steven M ^a   Sikorski, Robert A ^a   Konig, Gerhardt ^b   Tsilimigras, Diamantis I ^c   Hartmann, Jan ^d   Popovsky, Mark A ^d   Pawlik, Timothy M ^c   Waters, Jonathan H ^b  

^a DEPARTMENT OF PATHOLOGY   (United States)

^b UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE   (United States)

^c THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER   (United States)

^d HAEMONETICS CORPORATION   (United States)

Author keywords

Autologous blood; Cell salvage; Cell saver; Transfusion

Indexed keywords

ADVERSE EVENT; BLOOD AUTOTRANSFUSION; BLOOD SALVAGE; COST BENEFIT ANALYSIS; ECONOMICS; ERYTHROCYTE; HUMAN; OPERATIVE BLOOD LOSS; PEROPERATIVE CARE;

BLOOD LOSS, SURGICAL; BLOOD TRANSFUSION, AUTOLOGOUS; COST-BENEFIT ANALYSIS; ERYTHROCYTES; HUMANS; INTRAOPERATIVE CARE; OPERATIVE BLOOD SALVAGE;

EID: 85072051889     PISSN: 1091255X     EISSN: 18734626     Source Type: Journal    
DOI: 10.1007/s11605-019-04374-y     Document Type: Review

References (71)

1. Dodd RY. Emerging pathogens and their implications for the blood supply and transfusion transmitted infections. British journal of haematology. 2012;159(2):135–142.
2. Carson JL, Triulzi DJ, Ness PM. Indications for and adverse effects of red-cell transfusion. N Engl J Med. 2017;377(13):1261–1272.
3. Sadana D, Pratzer A, Scher LJ, et al. Promoting high-value practice by reducing unnecessary transfusions with a patient blood management program. JAMA Intern Med. 2018;178(1):116–122.
4. Halsted WS. Reinfusion in carbonic oxide poisoning. NY Med J. 1883.
5. Wilson JD, Taswell HF. Autotransfusion: Historical review and preliminary report on a new method. Mayo Clinic proceedings. 1968;43(1):26–35.
6. Sikorski RA, Rizkalla NA, Yang WW, Frank SM. Autologous blood salvage in the era of patient blood management. Vox sanguinis. 2017;112:499–510.
7. Scott AV, Nagababu E, Johnson DJ, et al. 2,3-Diphosphoglycerate concentrations in autologous salvaged versus stored red blood cells and in surgical patients after transfusion. Anesth Analg. 2016;122(3):616–623.
8. Heaton A, Keegan T, Holme S. In vivo regeneration of red cell 2,3-diphosphoglycerate following transfusion of DPG-depleted AS-1, AS-3 and CPDA-1 red cells. British journal of haematology. 1989;71(1):131–136.
9. Baskurt OK, Meiselman HJ. Blood rheology and hemodynamics. Semin Thromb Hemost. 2003;29(5):435–450.
10. Frank SM, Abazyan B, Ono M, et al. Decreased erythrocyte deformability after transfusion and the effects of erythrocyte storage duration. Anesth Analg. 2013;116(5):975–981.
11. Salaria ON, Barodka VM, Hogue CW, et al. Impaired red blood cell deformability after transfusion of stored allogeneic blood but not autologous salvaged blood in cardiac surgery patients. Anesth Analg. 2014;118(6):1179–1187.
12. Tinmouth A, Chin-Yee I. The clinical consequences of the red cell storage lesion. Transfus Med Rev. 2001;15(2):91–107.
13. Yazer MH, Waters JH, Elkin KR, Rohrbaugh ME, Kameneva MV. A comparison of hemolysis and red cell mechanical fragility in blood collected with different cell salvage suction devices. Transfusion. 2008;48(6):1188–1191.
14. Waters JH, Williams B, Yazer MH, Kameneva MV. Modification of suction-induced hemolysis during cell salvage. Anesth Analg. 2007;104(3):684–687.
15. Sistino JJ, Owitz D, Mongero LB. Heparin washout in the pediatric Cell Saver bowl. The journal of extra-corporeal technology. 1992;24(3):94–96.
16. Kling D, Borner U, von Bormann B, Hempelmann G. [Heparin elimination and free hemoglobin following cell separation and washing of autologous blood with Cell Saver 4]. Anasth Intensivther Notfallmed. 1988;23(2):88–90.
17. Gravlee GP, Hopkins MB, Yetter CR, Buss DH. Heparin content of washed red blood cells from the cardiopulmonary bypass circuit. J Cardiothorac Vasc Anesth. 1992;6(2):140–142.
18. Paravicini D, Schmitz-Huebner U, Stinnesbeck B. [Heparin elimination in intraoperative autotransfusion with the haemonetics cell saver]. Infusionstherapie und klinische Ernahrung. 1983;10(1):19–21.
19. Waters JH, Lee JS, Karafa MT. A mathematical model of cell salvage efficiency. Anesth Analg. 2002;95(5):1312–1317, table of contents.
20. Haynes SL, Bennett JR, Torella F, McCollum CN. Does washing swabs increase the efficiency of red cell recovery by cell salvage in aortic surgery? Vox sanguinis. 2005;88(4):244–248.
21. Carless PA, Henry DA, Moxey AJ, O’Connell D, Brown T, Fergusson DA. Cell salvage for minimising perioperative allogeneic blood transfusion. The Cochrane database of systematic reviews. 2010(4):CD001888.
22. So-Osman C, Nelissen RG, Koopman-van Gemert AW, et al. Patient blood management in elective total hip- and knee-replacement surgery (Part 1): A randomized controlled trial on erythropoietin and blood salvage as transfusion alternatives using a restrictive transfusion policy in erythropoietin-eligible patients. Anesthesiology. 2014;120(4):839–851.
23. So-Osman C, Nelissen RG, Koopman-van Gemert AW, et al. Patient blood management in elective total hip- and knee-replacement surgery (part 2): A randomized controlled trial on blood salvage as transfusion alternative using a restrictive transfusion policy in patients with a preoperative hemoglobin above 13 g/dl. Anesthesiology. 2014;120(4):852–860.
24. van Bodegom-Vos L, Voorn VM, So-Osman C, et al. Cell salvage in hip and knee arthroplasty: A meta-analysis of randomized controlled trials. J Bone Joint Surg Am. 2015;97(12):1012–1021.
25. Carson JL, Terrin ML, Noveck H, et al. Liberal or restrictive transfusion in high-risk patients after hip surgery. N Engl J Med. 2011;365(26):2453–2462.
26. Mazer CD, Whitlock RP, Fergusson DA, et al. Restrictive or liberal red-cell transfusion for cardiac surgery. N Engl J Med. 2017;377(22):2133–2144.
27. Murphy GJ, Pike K, Rogers CA, et al. Liberal or restrictive transfusion after cardiac surgery. N Engl J Med. 2015;372(11):997–1008.
28. Robertson CS, Hannay HJ, Yamal JM, et al. Effect of erythropoietin and transfusion threshold on neurological recovery after traumatic brain injury: A randomized clinical trial. Jama. 2014;312(1):36–47.
29. Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. New Engl J Med. 2013;368(1):11–21.
30. Holst LB, Haase N, Wetterslev J, et al. Lower versus higher hemoglobin threshold for transfusion in septic shock. N Engl J Med. 2014;371(15):1381–1391.
31. Hajjar LA, Vincent JL, Galas FR, et al. Transfusion requirements after cardiac surgery: The TRACS randomized controlled trial. Jama. 2010;304(14):1559–1567.
32. Hebert PC, Wells G, Blajchman MA, et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group. N Engl J Med. 1999;340(6):409–417.
33. Lacroix J, Hebert PC, Hutchison JS, et al. Transfusion strategies for patients in pediatric intensive care units. N Engl J Med. 2007;356(16):1609–1619.
34. Geoghegan J, Daniels JP, Moore PA, Thompson PJ, Khan KS, Gulmezoglu AM. Cell salvage at caesarean section: The need for an evidence-based approach. BJOG: an international journal of obstetrics and gynaecology. 2009;116(6):743–747.
35. Fong J, Gurewitsch ED, Kang HJ, Kump L, Mack PF. An analysis of transfusion practice and the role of intraoperative red blood cell salvage during cesarean delivery. Anesth Analg. 2007;104(3):666–672.
36. Allam J, Cox M, Yentis SM. Cell salvage in obstetrics. International journal of obstetric anesthesia. 2008;17(1):37–45.
37. Khan KS, Moore PAS, Wilson MJ, et al. Cell salvage and donor blood transfusion during cesarean section: A pragmatic, multicentre randomised controlled trial (SALVO). PLoS Med. 2017;14(12):e1002471.
38. Prick BW, Steegers EA, Jansen AJ, et al. Well being of obstetric patients on minimal blood transfusions (WOMB trial). BMC Pregnancy Childbirth. 2010;10:83.
39. Healy CF, Doyle M, Egan B, Hendrick B, O’Malley MK, O’Donohoe MK. Transfusion requirements and outcomes in patients undergoing abdominal aortic surgery using intra-operative cell salvage. Irish journal of medical science. 2007;176(1):33–36.
40. Serracino-Inglott F, Awad S, Barclay A, Nasim A. The use of a cell saver during repair of ruptured abdominal aortic aneurysms increases early survival. Annals of the Royal College of Surgeons of England. 2005;87(6):475.
41. Takagi H, Sekino S, Kato T, Matsuno Y, Umemoto T. Intraoperative autotransfusion in abdominal aortic aneurysm surgery: Meta-analysis of randomized controlled trials. Archives of surgery. 2007;142(11):1098–1101.
42. Markovic M, Davidovic L, Savic N, Sindjelic R, Ille T, Dragas M. Intraoperative cell salvage versus allogeneic transfusion during abdominal aortic surgery: Clinical and financial outcomes. Vascular. 2009;17(2):83–92.
43. Bridgens JP, Evans CR, Dobson PM, Hamer AJ. Intraoperative red blood-cell salvage in revision hip surgery. A case-matched study. J Bone Joint Surg Am. 2007;89(2):270–275.
44. Shenolikar A, Wareham K, Newington D, Thomas D, Hughes J, Downes M. Cell salvage auto transfusion in total knee replacement surgery. Transfusion medicine. 1997;7(4):277–280.
45. Huet C, Salmi LR, Fergusson D, Koopman-van Gemert AW, Rubens F, Laupacis A. A meta-analysis of the effectiveness of cell salvage to minimize perioperative allogeneic blood transfusion in cardiac and orthopedic surgery. International Study of Perioperative Transfusion (ISPOT) Investigators. Anesth Analg. 1999;89(4):861–869.
46. Wang G, Bainbridge D, Martin J, Cheng D. The efficacy of an intraoperative cell saver during cardiac surgery: A meta-analysis of randomized trials. Anesth Analg. 2009;109(2):320–330.
47. Niranjan G, Asimakopoulos G, Karagounis A, Cockerill G, Thompson M, Chandrasekaran V. Effects of cell saver autologous blood transfusion on blood loss and homologous blood transfusion requirements in patients undergoing cardiac surgery on- versus off-cardiopulmonary bypass: A randomised trial. Eur J Cardiothorac Surg. 2006;30(2):271–277.
48. Golab HD, Scohy TV, de Jong PL, Takkenberg JJ, Bogers AJ. Intraoperative cell salvage in infants undergoing elective cardiac surgery: A prospective trial. Eur J Cardiothorac Surg. 2008;34(2):354–359.
49. Frank SM, Rothschild JA, Masear CG, et al. Optimizing preoperative blood ordering with data acquired from an anesthesia information management system. Anesthesiology. 2013;118(6):1286–1297.
50. Frank SM, Thakkar RN, Podlasek SJ, et al. Implementing a health system-wide patient blood management program with a clinical community approach. Anesthesiology. 2017;127(5):754–764.
51. Waters JH, Dyga RM, Waters JF, Yazer MH. The volume of returned red blood cells in a large blood salvage program: where does it all go? Transfusion. 2011;51(10):2126–2132.
52. Frank SM. Who benefits from red blood cell salvage?--Utility and value of intraoperative autologous transfusion. Transfusion. 2011;51(10):2058–2060.
53. Shander A, Hofmann A, Ozawa S, Theusinger OM, Gombotz H, Spahn DR. Activity-based costs of blood transfusions in surgical patients at four hospitals. Transfusion. 2010;50(4):753–765.
54. Joseph SA, Jr., Berekashvili K, Mariller MM, et al. Blood conservation techniques in spinal deformity surgery: A retrospective review of patients refusing blood transfusion. Spine. 2008;33(21):2310–2315.
55. Resar LM, Wick EC, Almasri TN, Dackiw EA, Ness PM, Frank SM. Bloodless medicine: Current strategies and emerging treatment paradigms. Transfusion. 2016;56(10):2637–2647.
56. Resar LM, Frank SM. Bloodless medicine: What to do when you can’t transfuse. Hematology / the Education Program of the American Society of Hematology American Society of Hematology Education Program. 2014;2014(1):553–558.
57. Poruk KE, Valero V, 3rd, Saunders T, et al. Circulating tumor cell phenotype predicts recurrence and survival in pancreatic adenocarcinoma. Ann Surg. 2016;264(6):1073–1081.
58. Waters JH, Donnenberg AD. Blood salvage and cancer surgery: Should we do it? Transfusion. 2009;49(10):2016–2018.
59. Catling S, Williams S, Freites O, Rees M, Davies C, Hopkins L. Use of a leucocyte filter to remove tumour cells from intra-operative cell salvage blood. Anaesthesia. 2008;63(12):1332–1338.
60. Beck-Schimmer B, Romero B, Booy C, et al. Release of inflammatory mediators in irradiated cell salvage blood and their biological consequences in human beings following transfusion. European journal of anaesthesiology. 2004;21(1):46–52.
61. Connor JP, Morris PC, Alagoz T, Anderson B, Bottles K, Buller RE. Intraoperative autologous blood collection and autotransfusion in the surgical management of early cancers of the uterine cervix. Obstetrics and gynecology. 1995;86(3):373–378.
62. Nieder AM, Manoharan M, Yang Y, Soloway MS. Intraoperative cell salvage during radical cystectomy does not affect long-term survival. Urology. 2007;69(5):881–884.
63. Stoffel JT, Topjian L, Libertino JA. Analysis of peripheral blood for prostate cells after autologous transfusion given during radical prostatectomy. BJU Int. 2005;96(3):313–315.
64. Kumar N, Ahmed Q, Lee VK, et al. Can there be a place for intraoperative salvaged blood in spine tumor surgery? Annals of surgical oncology. 2014;21(7):2436–2443.
65. Kang R, Seath BE, Huang V, Barth RJ, Jr. Impact of Autologous Blood Transfusion on Survival and Recurrence among Patients Undergoing Partial Hepatectomy for Colorectal Cancer Liver Metastases. J Am Coll Surg. 2019;228(6):902–908.
66. Amato A, Pescatori M. Perioperative blood transfusions for the recurrence of colorectal cancer. The Cochrane database of systematic reviews. 2006(1):CD005033.
67. Waters JH, Yazer M, Chen YF, Kloke J. Blood salvage and cancer surgery: A meta-analysis of available studies. Transfusion. 2012;52(10):2167–2173.
68. Waters JH, Tuohy MJ, Hobson DF, Procop G. Bacterial reduction by cell salvage washing and leukocyte depletion filtration. Anesthesiology. 2003;99(3):652–655.
69. Dzik W. Use of leukodepletion filters for the removal of bacteria. Immunol Invest. 1995;24(1–2):95–115.
70. Ozmen V, McSwain NE, Jr., Nichols RL, Smith J, Flint LM. Autotransfusion of potentially culture-positive blood (CPB) in abdominal trauma: preliminary data from a prospective study. J Trauma. 1992;32(1):36–39.
71. Bowley DM, Barker P, Boffard KD. Intraoperative blood salvage in penetrating abdominal trauma: a randomised, controlled trial. World J Surg. 2006;30(6):1074–1080.