title: Are we cross-matching too much blood for elective open abdominal aortic aneurysm repair?
abstract: OBJECTIVE
  This study aims to identify current blood transfusion requirements in elective open abdominal aortic aneurysm repair and to compare this to an existing maximum surgical blood order schedule.
  
  
  METHODS
  We retrospectively identified patients who underwent elective open abdominal aortic aneurysm repair over a 40-month period in our institution. Pre-operative number of units cross-matched and the number of units actually transfused were identified. The cross-match to transfusion ratio was then calculated.
  
  
  RESULTS
  Blood transfusion at any time post-operatively was required in 23 (48.9%) cases. Patients needing an intra-operative blood transfusion had a median of 2 units. Of the pre-operative cross-matched units (123), only 43 were used, giving a cross-match to transfusion ratio of 2.86.
  
  
  CONCLUSIONS
  Our current maximum surgical blood order schedule is poorly followed and a cross-match to transfusion ratio of 2.86 indicates we are cross-matching too many units for elective open abdominal aortic aneurysm repair. A carefully considered individualised management of blood products, with the requirement of at least a valid group and save sample, may be more appropriate.
authors.affiliation: Department of Vascular Surgery, Royal Derby Hospital, Derby, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Lowe
authors.affiliation: Department of Vascular Surgery, Royal Derby Hospital, Derby, UK.
authors.forename: John
authors.initials: J
authors.lastname: Quarmby
keywords: Elective; aneurysm; autologous transfusion