[Mechanical autotransfusion also in transurethral resection of prostatic adenoma? Studies of preserved washed erythrocyte concentrates before possible retransfusion].
OBJECTIVE
Does cell-saving during transurethral resection of prostatic adenoma (TURP) provide autologous washed erythrocyte concentrates (AWECs) of the same haematological and bacteriological quality as that of established indications of a cell-saving device? Should the cell-saving device be used routinely in TURP?


METHODS
37 patients underwent TURP with written, informed consent. All patients had antibiotic therapy prior to surgery. Shed blood was processed by a cell-saving device. AWECs specimens were analysed for red blood count, electrolytes, LDH, extracellular haemoglobin, osmotic fragility, blood culture and bacterial concentration. In addition, data of urine cultures, adenoma cultures and adenoma histology were analysed. AWEcs were not retransfused.


RESULTS
Haematological quality was shown to be comparable to that of established applications of a cell-saving device. However, 82% of the AWECs were contaminated with bacteria. Concentrations were as high as > 10(6) bacteria/ml. Isolated bacteria ranged from e. coli and pseudomonas to staphylococci, streptococci and candidae. Bacteria found in the urine cultures of patients with urinary tract infections could also be isolated in their AWECs. 16% of the patients had prostatic cancer not know preoperatively. Mass of resected adenoma and volume of AWEC did not correlate.


CONCLUSIONS
In despite of good haematological quality we considered the rate of 82% bacterial and 16% tumour cell contamination of the AWECs unacceptable and, contrary to some literature data, we no longer use a cell-saving device in TURP.
Tumbass
V E
VE
Anästhesieabteilung Kreiskrankenhaus Bad Urach.
Schmitt
Y
Y
Schöter
G
G
Henn-Beilharz
A
A
Krier
C
C
D000368:Aged; D001769:Blood / Q000382:microbiology; D016063:Blood Loss, Surgical / Q000503:physiopathology; D001804:Blood Transfusion, Autologous / Q000295:instrumentation*; D015169:Colony Count, Microbial; D017707:Erythrocyte Transfusion / Q000295:instrumentation*; D006452:Hemoglobinometry; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D011468:Prostatectomy / Q000295:instrumentation*; D011470:Prostatic Hyperplasia / Q000097:blood / Q000601:surgery*
D007770:L-Lactate Dehydrogenase; D011188:Potassium
Maschinelle Autotransfusion (MAT) auch bei der transurethralen Resektion des Prostata-Adenoms (TUR-P)? Untersuchungen der aufbereiteten gewaschenen Erythrozyten-Konzentrate (AGEK) vor einer möglichen Retransfusion.