Cell salvage for minimising perioperative allogeneic blood transfusion

Cell salvage appears to be effective in reducing the need for allogeneic red cell transfusion in adult elective cardiac and orthopaedic surgery.

A Cochrane review (abstract , review ) included 75 studies. Cell salvage (CS), alternatively known as 'auto-transfusion', is a term that covers a range of techniques that scavenge blood from operative fields or wound sites, and re-infuse the blood back into the patient. Overall, the use of cell salvage reduced the rate of exposure to allogeneic RBC transfusion by a relative 38% (RR 0.62, 95% CI 0.55 to 0.70, statistical heterogeneity I² 81%; 67 studies, n= 6 025). The absolute reduction in risk (ARR) of receiving an allogeneic RBC transfusion was 21% (95% CI 15% to 26%). In orthopaedic procedures the RR of exposure to RBC transfusion was 0.46 (95% CI 0.37 to 0.57, statistical heterogeneity I² 62%; 32 studies,n= 3 240) compared to 0.77 (95% CI 0.69 to 0.86, statistical heterogeneity I² 72%; 31 studies, n= 2 518) for cardiac procedures. The use of cell salvage resulted in an average saving of 0.68 units of allogeneic RBC per patient (WMD –0.68, 95% CI –0.88 to –0.49, statistical heterogeneity I² 75%; 32 studies, n= 2 321). Cell salvage did not appear to impact adversely on clinical outcomes.

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear blinding and allocation concealment).

Ədəbiyyat

1. Carless PA, Henry DA, Moxey AJ, O'Connell D, Brown T, Fergusson DA. Cell salvage for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev 2010;(4):CD001888.