Autotransfusion with cell saver for off-pump coronary artery bypass surgery: a randomized trial.
OBJECTIVE
Off-pump coronary surgery reduces transfusions, however, many patients still receive blood. This trial aims to clarify the effect of using a cell saver intraoperatively.


METHODS
In 60 patients shed blood was collected in the cell saver reservoir intraoperatively; randomization and processing or discharge were performed immediately after surgery.


METHODS
proportion of patients receiving allogeneic blood, and average number of units per patient.


METHODS
blood loss, hemoglobin levels, complications, and costs.


RESULTS
Cell saver group versus control group; received transfusions: 17/30 vs. 14/29 (p = 0.28), allogeneic units: median 1 (interquartile range 0 - 2) vs. 2 (IQR 0 - 7) (p = 0.06), intraoperative net blood loss: median 300 ml (IQR 193 - 403) vs. 610 ml (IQR 450 - 928) (p < 0.001). Control group patients had more complications leading to transfusion. Hemoglobin levels and costs were comparable between groups.


CONCLUSIONS
Use of cell saver reduced intraoperative net blood loss and seemed to reduce transfusions by 1 unit per patient, however, this was probably attributable to more complications leading to transfusion in the control group. In the future larger trials are necessary.
Damgaard
Sune
S
Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Denmark. sunedamgaard@dadlnet.dk
Steinbrüchel
Daniel A
DA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001804:Blood Transfusion, Autologous / Q000295:instrumentation*; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged