title: Washed cell salvage in surgical patients: A review and meta-analysis of prospective randomized trials under PRISMA.
abstract: BACKGROUND
  Cell salvage is commonly used as part of a blood conservation strategy. However concerns among clinicians exist about the efficacy of transfusion of washed cell salvage.
  
  
  METHODS
  We performed a meta-analysis of randomized controlled trials in which patients, scheduled for all types of surgery, were randomized to washed cell salvage or to a control group with no cell salvage. Data were independently extracted, risk ratio (RR), and weighted mean differences (WMD) with 95% confidence intervals (CIs) were calculated. Data were pooled using a random effects model. The primary endpoint was the number of patients exposed to allogeneic red blood cell (RBC) transfusion.
  
  
  RESULTS
  Out of 1140 search results, a total of 47 trials were included. Overall, the use of washed cell salvage reduced the rate of exposure to allogeneic RBC transfusion by a relative 39% (RR = 0.61; 95% CI 0.57 to 0.65; P < 0.001), resulting in an average saving of 0.20 units of allogeneic RBC per patient (weighted mean differences [WMD] = -0.20; 95% CI -0.22 to -0.18; P < 0.001), reduced risk of infection by 28% (RR = 0.72; 95% CI 0.54 to 0.97; P = 0.03), reduced length of hospital stay by 2.31 days (WMD = -2.31; 95% CI -2.50 to -2.11; P < 0.001), but did not significantly affect risk of mortality (RR = 0.92; 95% CI 0.63 to 1.34; P = 0.66). No statistical difference could be observed in the number of patients exposed to re-operation, plasma, platelets, or rate of myocardial infarction and stroke.
  
  
  CONCLUSIONS
  Washed cell salvage is efficacious in reducing the need for allogeneic RBC transfusion and risk of infection in surgery.
authors: Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt Institute for Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Germany.
authors: Patrick
authors: P
authors: Meybohm
authors: Suma
authors: S
authors: Choorapoikayil
authors: Anke
authors: A
authors: Wessels
authors: Eva
authors: E
authors: Herrmann
authors: Kai
authors: K
authors: Zacharowski
authors: Donat R
authors: DR
authors: Spahn
mesh_terms: D001800:Blood Specimen Collection / Q000379:methods; D001804:Blood Transfusion, Autologous; D017707:Erythrocyte Transfusion; D006801:Humans; D007902:Length of Stay; D057725:Operative Blood Salvage / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic; D013530:Surgical Wound Infection / Q000517:prevention & control