Intraoperative blood salvage

Intraoperative blood salvage (also known as autologous blood transfusion or cell salvage) is a medical procedure that involves recovering blood lost during surgery and reinfusing it into the patient. It is a major component of Patient Blood Management strategies, which aim to minimize the use of allogenic (donor) blood transfusions.

History

The concept of intraoperative blood salvage was first introduced in the 1970s, as a response to the increasing demand for blood transfusions and the associated risks of bloodborne disease transmission and transfusion reactions.

Procedure

Intraoperative blood salvage involves three main steps: collection, processing, and reinfusion.

• Collection: Blood is collected from the surgical site using a specialized suction device. This can be done continuously throughout the surgery or at specific intervals.

• Processing: The collected blood is then processed to remove any debris, such as tissue fragments or clotting factors. This is typically done using a cell salvage machine, which uses centrifugation to separate the red blood cells from the other components.

• Reinfusion: The processed blood is then reinfused into the patient, either directly or after being stored for a short period of time.

Benefits and Risks

The main benefit of intraoperative blood salvage is that it reduces the need for allogenic blood transfusions, which can carry risks such as disease transmission, transfusion reactions, and immunomodulatory effects. It can also provide a solution for patients who refuse blood transfusions for religious or personal reasons, such as Jehovah's Witnesses.

However, intraoperative blood salvage is not without risks. These can include contamination of the salvaged blood with bacteria or cancer cells, and the potential for air embolism during reinfusion. Therefore, it is not suitable for all types of surgery, and the decision to use it should be made on a case-by-case basis.

See Also

• Blood transfusion
• Patient Blood Management
• Bloodborne diseases
• Transfusion reaction