title: Intraoperative red blood cell salvage and autologous transfusion during open radical retropubic prostatectomy: a cost-benefit analysis.
abstract: BACKGROUND
  Open radical retropubic prostatectomy (RRP) has an average blood loss of over 1,000 ml. This has been reported even from high volume centres of excellence. We have looked at the clinical and financial benefits of using intraoperative cell salvage (ICS) as a method of reducing the autologous blood transfusion requirements for our RRP patients.
  
  
  METHODS
  Group A comprised 25 consecutive patients who underwent RRP immediately prior to the acquisition of a cell saver machine. Group B consisted of the next 25 consecutive patients undergoing surgery using the Dideco Electa (Sorin Group, Italy) cell saver machine. Blood transfusion costs for both groups were calculated and compared.
  
  
  RESULTS
  The mean postoperative haemoglobin was similar in both groups (11.1 gm/dl in Group A and 11.4 gm/dl in Group B). All Group B patients received autologous blood (average 506 ml, range: 103-1,023 ml). In addition, 5 patients (20%) in Group B received a group total of 16 units (average 0.6 units) of homologous blood. For Group A the total cost of transfusing the 69 units of homologous blood was estimated as £9,315, based on a per blood unit cost of £135. This cost did not include consumables or nursing costs.
  
  
  CONCLUSIONS
  We found no evidence that autologous transfusions increased the risk of early biochemical relapse or of disease dissemination. ICS reduced our dependence on donated homologous blood.
authors: Department of Urology, Southport District and General Hospital, Southport, Merseyside, UK. sarv21@hotmail.com
authors: Sarvpreet
authors: S
authors: Ubee
authors: Manal
authors: M
authors: Kumar
authors: Nallaswami
authors: N
authors: Athmanathan
authors: Gurpreet
authors: G
authors: Singh
authors: Sean
authors: S
authors: Vesey
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001804:Blood Transfusion, Autologous / Q000191:economics* / Q000706:statistics & numerical data; D016022:Case-Control Studies; D003362:Cost-Benefit Analysis; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D057725:Operative Blood Salvage / Q000191:economics*; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011468:Prostatectomy / Q000191:economics*; D011471:Prostatic Neoplasms / Q000191:economics* / Q000601:surgery
chemical_list: D006454:Hemoglobins; D017430:Prostate-Specific Antigen