AUTOTRANSFUSION OVERVIEW

Autotransfusion is a non-invasive procedure in which autologous blood lost by or removed from a patient undergoing surgery in an operating room is subsequently reinfused to the patient.  Component preparation may also be carried out and products sequestered prior to surgery for reinfusion following completion of surgery and securing of bleeding points and surfaces.  The sequestered products include red cells, plasma, and platelet concentrate.  The latter may also be employed to prepare platelet gel, which can be used as a surgical sealant with properties to promote healing (platelet-derived growth factors).

ADVANTAGES OF AUTOTRANSFUSION OVER ALLOGENEIC TRANSFUSION

Blood-related diseases have focused attention on the risks of allogeneic transfusion and have resulted in increased interest in autotransfusion.  There are several benefits to autotransfusion. 

1.         Transmissible viral disease risk is eliminated, as well as other non-screenable viral blood-transmitted diseases.

2.         Cross-matching errors are eliminated.

3.         Patients opposed to allogeneic transfusion for religious reasons, such as Jehovah's Witnesses have often accepted the autotransfusion circuit as simply an extension of their bodies' natural circulation.

4.         Autologous blood provides significant additional assurance when operating on surgical subjects with multiple blood group antibodies or rare blood phenotypes.

5.         Banked blood inventory may be conserved, particularly at times of blood shortages.   Significant cost containment may be realized.

INDICATIONS FOR AUTOTRANSFUSION

This service incorporates the collection, concentration, washing and reinfusion of autologous blood and/or autologous blood components during surgical, or other trauma treatment procedures, where autologous blood may be properly salvaged from wounds and/or body cavities in "autotransfusion" support of the patient's blood transfusion requirements.  Such areas of application may include, but are not necessarily limited to, the following:

• Cardiovascular surgery
• Orthopedic surgery
• Trauma surgery
• General Surgery
• Neurosurgery
• Plastic/Reconstructive surgery
• Obstetric/Gynecologic surgery
• Emergency Room/Trauma Center treatment

Additionally, this device is intended for use in the collection, concentration and reinfusion of autologous blood components that may be sequestered from venous access during the perioperative period in appropriate elective or emergent surgery in order to provide support of patient's blood component transfusion requirements.  Such areas of application may include, but are not necessarily limited to the following:

• Cardiovascular surgery
• Orthopedic surgery
• ENT (ear-nose-throat) surgery
• General Surgery
• Neurosurgery
• Plastic/Reconstructive surgery
• Obstetric/Gynecologic surgery
• Trauma surgery

Autotransfusion is indicated when:

1.         Red cells conservation is chosen by the physician or the patient as an alternative to allogeneic blood transfusion.

2.         Replacement with allogeneic blood may increase morbidity and mortality.

3.         No other blood is available and the patient's hematocrit is lower than 24%.

4.         No blood can be cross-matched or more blood is required than is readily available.

5.         The religious beliefs of the patient permit acceptance of fresh autologous blood, but    not Blood Bank products, as with some Jehovah's Witnesses.