[The present possibilities for routine use of blood-saving measures from the anesthesiologic point of view--theoretical basis and clinical practice. II: Perioperative retransfusion of acute blood loss; plasmapheresis].
Intra- and postoperative blood-salvage with consecutive retransfusion represent an established part within the "Concept of Autologous Transfusion (CAT)". According to the processing technique of the blood salvaged there exist two different systems: Autologous Transfusion System II (ATS II) and Autologous Transfusion System III (ATS III). By using ATS II blood (with or without anticoagulation) is collected within a collecting reservoir after having passed a rough-filter-system. Passing a fine-filter-system the blood collected is retransfused into the patient without any preceding processing (autologous direct-retransfusion, ADR). Because of the activation of the coagulation proteins by the tissue and by the collection system as well as due to the destroyed red blood cells, the white blood cells, the platelets and the free plasma hemoglobin the patient is transfused with an autologous "whole-blood-like product" of minor quality. By administration of ATS III blood is collected and anticoagulated and passes a rough-filter as well; by processing the blood by means of centrifugation and separation and by washing the damaged red blood cells, a great part of the white blood cells, of the platelets and of the plasma hemoglobin (and of the anticoagulatory drug) is eliminated resulting in a washed autologous product, which mainly consists of red blood cells, which are retransfused into the patient through a fine-filter system. This means, that the autologous product obtained by the two different systems differs both regarding its quality and the plasmatic and corpuscular contents. However, undoubtedly either system is able to effectively reduce the need for homologous blood.(ABSTRACT TRUNCATED AT 250 WORDS)
Singbartl
G
G
Abteilung Anästhesiologie, Intensive- und Transfusionsmedizin, ENDO-KLINIK Hamburg.
Schleinzer
W
W
D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000379:methods*; D006801:Humans; D010956:Plasmapheresis / Q000379:methods*
Perioperative Retransfusion akuter Blutverluste; Plasmapherese.