The impact of introducing an autologous intraoperative transfusion device to a community hospital.
The purpose of this study was to determine the benefits and disadvantages of transfusing autologous blood during abdominal aortic aneurysm (AAA) surgery at a district general hospital with an intraoperative autologous transfusion device (Haemoccel ABT 350). In this retrospective study, 128 patients underwent abdominal aortic aneurysm repair between 1992 and 1999 by a single vascular surgeon. Ninety-three patients (60 autologous and 33 allogeneic) had elective AAA repair (group A) and 25 patients (4 autologous and 21 allogeneic) had emergency AAA repair (group B). Nine group A patients (7.6%) received their own salvaged blood and no other allogeneic blood. Although the mean estimated blood loss was higher in the autologous group of patients (NS), the intraoperative autologous transfusion device did not significantly reduce allogeneic blood usage in patients who had autologous transfusion in both elective and emergency groups. There was no difference in postoperative hemoglobin and hematocrit, ICU stay or hospital stay. In this study, red cell salvage was significantly more expensive than blood bank usage (p < 0.0001), yet it did not significantly reduce the needs of allogeneic blood. We concluded that the intraoperative autologous transfusion device is underused, not cost-effective and requires formulation of local guidelines.
Shuhaiber
Jeffrey H
JH
Department of Surgery, Conquest Hospital, Hastings and Rother NHS Trust, The Ridge St Leonards-on Sea, East Sussex, TN37 7RD, UK. Shuhaibr@uic.edu
Whitehead
Steven M
SM
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000191:economics / Q000295:instrumentation*; D003362:Cost-Benefit Analysis; D017558:Elective Surgical Procedures; D004630:Emergencies; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors