PERIOPERATIVE BLOOD SALVAGE

Perioperative Blood Salvage is the collection and reinfusion of blood lost during and immediately after surgery. The blood from the surgical field is recovered, mixed with an anticoagulant and pumped through a cell salvage machine where it is centrifuged and washed. The resulting red blood cells are then pumped into a transfer bag. The blood may be reinfused to the patient immediately or at a later time.

The use of perioperative blood salvage can reduce or eliminate the patient’s need for allogeneic blood transfusion and can be an alternative or complement to autologous blood donation. Patients requiring two or more units of blood during surgery can benefit from this program. Perioperative salvage may be used for patients undergoing vascular, orthopedic, urologic, gynecological and cardiac surgery. Other procedures where perioperative salvage may be useful are splenectomy and liver resection as well as organ transplantation.

Contraindications

Since no blood filtering or blood washing system can completely eliminate bacteria, infection can occur. Bacterial contamination of salvaged blood can occur in procedures with spilled intestinal contents, bacterial peritonitis, abscesses, or osteomyelitis.

Malignant cells in salvaged blood cannot be completely removed by washing or filtration. There is a theoretical risk of metastases when transfusing salvaged blood during surgery for malignancy.

Perioperative blood salvage programs operate under AABB and CAP guidelines. Go to www.aabb.org for more information.