CELL SALVAGE

Blood salvage use in gynecologic oncology. Transfusion. 2009 Jun 23. [Epub ahead of print] In this series of patients undergoing surgery for malignancies on the gynecologic oncology service, blood salvage with leukoreduction filter was not definitively associated with hematogenous dissemination. Further large controlled studies are needed to demonstrate the clinical safety of the use of blood salvage in this setting.

Cell salvage at caesarean section: the need for an evidence-based approach. BJOG. 2009 May;116(6):743-7 Haemorrhage, a leading cause of maternal morbidity and mortality, is frequently associated with caesarean section. Allogeneic blood is an increasingly rare and scare resource. Intraoperative Cell Salvage (IOCS) offers the possibility of improving outcome and reducing allogeneic blood transfusion in cases of haemorrhage at caesarean section. The available literature on the use of IOCS in obstetrics demonstrates that there is limited evidence to support or refute the use of IOCS at caesarean section.

[A case of caesarean section using Cell Savers5+ in a patient with the placenta accreta associated with massive hemorrhage] Masui. 2009 Apr;58(4):499-502. Japanese. Case report

Impact of intraoperative red blood cell salvage on transfusion requirements and outcomes in radical prostatectomy.Transfusion. 2009 Mar 20. [Epub ahead of print] Perioperative CS can effectively replace PAD for RP patients, offering similar avoidance of allogeneic transfusion, with greater convenience and superior postoperative Hb levels.

Introduction of cell salvage to a large obstetric unit: the first six months. Int J Obstet Anesth. 2009 Jan 12. [Epub ahead of print]For the unit as a whole the percentage of all theatre cases who received a heterologous transfusion fell from 10.2% for the equivalent time period in the preceding year to 7.9% during the six month period that cell salvage was in use (P=0.126, chi(2)). There were no adverse reactions following the administration of processed blood.

Intraoperative autologous blood recovery in prostate cancer surgery: in vivo validation using a tumour marker. Vox Sang. 2008 Nov;95(4):308-12. Even though the risk of disseminating tumour cells in prostate cancer surgery by intraoperative autologous blood recovery is not yet fully established, no tumour-specific gene amplification was found after the association of blood filtration and irradiation, suggesting a significant reduction of such risk

Use of a leucocyte filter to remove tumour cells from intra-operative cell salvage blood. Anaesthesia. 2008 Dec;63(12):1332-8. After passage through a Pall RS leucocyte depletion filter no remaining viable, nucleated malignant cells were detected in any sample. The clinical risks of cell salvage in these circumstances should be reviewed in the light of the risks of allogeneic blood transfusion.

The Haemonetics(R) Cell Saver 5 washing properties: effect of different washing pump and centrifuge speeds.

Interact Cardiovasc Thorac Surg. 2008 Jul 17 . 2008 Jul 17. 2008 Jul 17. [Epub ahead of print]This study evaluated the effect of different washing and centrifuge rates of the Cell Saver 5 on the quality of processed autologous blood.

Do repeated runs of a cell saver device increase the pro-inflammatory properties of washed blood?

Eur J Cardiothorac Surg. 2008 Jun 6. [Epub ahead of print]Results suggest, based on interleukin-6 and free hemoglobin washout that the quality of the processed blood remains constant with multiple runs of the cell saver device.

Intraoperative cell salvage in infants undergoing elective cardiac surgery: a prospective trial.

Eur J Cardiothorac Surg. 2008 Jun 5. [Epub ahead of print]Intraoperative cell salvage, employed as an adjuvant technique to the residual volume salvage in infants undergoing first time cardiac surgery with cardiopulmonary bypass, was a safe and effective method to reduce postoperative allogeneic blood transfusion. Considering current cell salvage related expense and the cost reduction achieved by diminished allogeneic transfusion, intraoperative cell salvage in infants demonstrated no economic benefit.

The utility of an autologous blood salvage system in emergency thoracotomy for a hemothorax after chest trauma.

Gen Thorac Cardiovasc Surg. 2008 May;56(5):222-5. Epub 2008 May 11. When no banked blood is available for an emergency thoracotomy, the Cell Saver is an extremely useful machine. This device is also effective in treating progressive hemorrhagic shock and helpful when the rate of blood loss exceeds the supply available from the blood bank.

Intraoperative blood salvage during liver transplantation in patients with hepatocellular carcinoma: efficiency of leukocyte depletion filters in the removal of tumor cells.

Transplantation. 2008 Mar 27;85(6):863-9. Blood filtration with the depletion filters LDFs can efficiently remove tumor cells and the use of an additional LDF after use of the Cell Saver could markedly reduce the risk of tumor cell reintroduction during the OLT in HCC recipients with nonruptured tumors.

Re-transfusion of salvaged washed red cells improves clot formation in pigs as measured by rotational thrombelastometry (ROTEM).

Eur J Anaesthesiol. 2008 Feb 26;:1-6 [Epub ahead of print] In the case of extreme isovolaemic haemodilution, increasing the circulating red cell mass by re-transfusing salvaged red blood cells did not worsen the findings of dilutional coagulopathy but interestingly, at least partially, improves the clot formation process.

Implementation of the Continuous AutoTransfusion System (C.A.T.S) in Open Abdominal Aortic Aneurysm Repair: An Observational Comparative Cohort Study.

Vasc Endovascular Surg. 2008 Feb-Mar;42(1):32-9. The C.A.T.S markedly reduced the amount of blood transfused, was associated with reduced intensive care unit and postoperative hospital stay, and was cost-effective.

Implementation of the Continuous AutoTransfusion System (C.A.T.S) in Open Abdominal Aortic Aneurysm Repair: An Observational Comparative Cohort Study.

Successful blood conservation during craniosynostotic correction with dual therapy using procrit and cell saver.

J Craniofac Surg. 2008 Jan;19(1):101-5. For elective craniosynostotic correction, successful blood conserving dual therapy with Procrit and Cell Saver might be used to decrease transfusion rates and the need for any blood products.

Efficacy and economics of postoperative blood salvage in patients undergoing elective total hip replacement.

Effect of autologous blood transfusion on the rate of biochemical recurrence after radical prostatectomy.
BJU Int. 2007 Sep 10; [Epub ahead of print] Perioperative autologous blood transfusion does not predispose to a higher rate of biochemical recurrence in patients after radical prostatectomy .

Transfusion requirements and outcomes in patients undergoing abdominal aortic surgery using intra-operative cell salvage.
Ir J Med Sci. 2007 Mar;176(1):33-6. Intraoperative cell salvage is a safe procedure and substantially reduces the need for blood transfusion in patients undergoing abdominal aortic surgery. It may substantially alleviate shortages of allogenic blood and should be part of the armamentarium of vascular units.

Post-operative blood salvage with autologous retransfusion in primary total hip replacement.
J Bone Joint Surg Br. 2007 Aug;89-B(8):1092-7. A prospective randomised study to analyse differences in postoperative haemoglobin levels and homologous blood requirements in two groups of patients undergoing primary total hip replacement.

Microbiologic contamination of intraoperative blood salvaged during liver transplantation.
Transplant Proc. 2007 Jul-Aug;39(6):1889-91. Although almost 70% of processed and reinfused units tested positive for microbes, none of the postoperative blood cultures (at day 1 and day 3) revealed growth of the same species, not even in the 2 patients who had positive CVC cultures after induction of anesthesia.

Management of ruptured corpus luteum cyst of pregnancy occurring in a 15-year-old girl by laparoscopic surgery with intraoperative autologous blood transfusion.
J Pediatr Adolesc Gynecol. 2007 Apr;20(2):97-100. Ruptured corpus luteum cyst of pregnancy manifesting massive hemoperitoneum is a rare but life-threatening disorder that can occur even in a young girl. Ovarian conservative treatment can laparoscopically be performed with intraoperative autologous blood transfusion.

An economic analysis of costs associated with development of a cell salvage program.
Anesth Analg. 2007 Apr;104(4):869-75. This analysis suggests that cell salvage can be significantly less expensive than allogeneic blood. The cost of cell salvage in other institutions will vary depending upon case volume, expected levels of blood loss per case, and initial investment costs. A step-by-step formula is provided to assist in the evaluation of a cell salvage service in hospitals of various sizes

Modification of suction-induced hemolysis during cell salvage.
Anesth Analg. 2007 Mar;104(3):684-7. Significant reduction of blood damage can be obtained by diluting blood with normal saline while suctioning it from the surgical field. Although immediate hemolysis due to suctioning was not very high, the red blood cell damage from suctioning produced by a dynamic blood-air interface might adversely affect the efficiency of cell salvage.

Interleukin-6 Enhancement after Direct Autologous Retransfusion of Shed Thoracic Blood does not Influence Haemodynamic Stability Following Coronary Artery Bypass Grafting.
Thorac Cardiovasc Surg. 2007 Mar;55(2):68-72. This study found significantly elevated plasma IL-6 levels following direct autologous retransfusion of shed thoracic blood but failed to show severe adverse effects affecting haemodynamic stability.

Decreasing the blood transfusion rate in elective hip replacement surgery using an autologous drainage system.
Ann R Coll Surg Engl. 2007 Mar;89(2):136-9. This is a prospective study looking at the effectiveness of autologous postoperative drains in primary uncemented total hip replacement (THR) surgery.The mean number of units of homologous blood transfused per patient was reduced from 0.86 to 0.12 (P < 0.01) with the use of autologous drains and the transfusion rate was reduced from 23% to 6% (P < 0.02). The mean length of hospital stay was also reduced by two nights (P < 0.05). There were no adverse effects from using the autologous system and it does reduce the need for a homologous blood transfusion.

Retransfusion of filtered shed blood in primary total hip and knee arthroplasty: a prospective randomized clinical trial.
Transfusion. 2007 Mar;47(3):379-84. Postoperative retransfusion of filtered shed blood is effective for decreasing allogeneic blood transfusions after total hip and knee arthroplasty. There was no relationship between retransfusions and postoperative febrile reactions.

An analysis of transfusion practice and the role of intraoperative red blood cell salvage during cesarean delivery.
Anesth Analg. 2007 Mar;104(3):666-72. Theoretically, based on best, average, and worst RBC salvage recovery calculations, 25.1%, 21.2%, or 14.5% of the appropriately transfused patients, respectively, could have completely avoided allogenic RBC transfusion

Peri-operative blood management in elective orthopaedic surgery. A critical review of the literature.
Injury. 2006 Dec;37 Suppl 5:S11-6. Review

Cell salvage for minimising perioperative allogeneic blood transfusion.
Cochrane Database Syst Rev. 2006 Oct 18;(4):CD001888. Review. The results suggest cell salvage is efficacious in reducing the need for allogeneic red cell transfusion in adult elective surgery. However, the methodological quality of trials was poor.

Cost-effectiveness of cell salvage and alternative methods of minimising perioperative allogeneic blood transfusion: a systematic review and economic model.
Health Technol Assess. 2006 Nov;10(44):iii-iv, ix-x, 1-210. Review. The available evidence indicates that cell salvage may be a cost-effective method to reduce exposure to allogeneic blood transfusion. FULL TEXT