Intra-operative autotransfusion in radical cystectomy.
OBJECTIVE
To assess the feasibility of intra-operative autotransfusion (IAT) as a method of decreasing or avoiding homologous blood transfusion during radical cystectomy.


METHODS
IAT was performed in 10 patients with bladder cancer who underwent radical cystectomy. The patients were divided into two groups: group 1 consisted of six patients without and group 2 of four patients with pre-deposited blood. Blood shed in the operative field was collected and processed with an IAT device.


RESULTS
In group 1, the intra-operative blood loss ranged from 1.08 to 2.67 L (mean 1.82) and homologous blood transfusion ranged from 0 to 1 L (mean 0.47). The amount of autologous blood processed and transfused by the IAT device ranged from 0.38 to 0.98 L (mean 0.64). Two patients did not require homologous blood transfusion. In group 2, the volume of pre-deposited blood ranged from 0.8 to 1.2 L (mean 0.9). The intra-operative blood loss ranged from 1.03 to 3.24 L (mean 1.8). The amount of processed autologous blood transfused ranged from 0.4 to 0.6 L (mean 0.45). None of the patients in group 2 required homologous blood transfusion.


CONCLUSIONS
Although there are theoretical risks with IAT, they were not substantiated by the clinical data. IAT seems to be a feasible method of reducing or avoiding homologous blood transfusion in radical cystectomy. These results suggest that IAT in combination with pre-deposited blood will abolish the need for homologous blood transfusion during radical cystectomy.
Park
K I
KI
Department of Urology, Shiga University of Medical Science, Otsu, Japan.
Kojima
O
O
Tomoyoshi
T
T
D000368:Aged; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000379:methods*; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006400:Hematocrit; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011182:Postoperative Care; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery*