Safety and efficacy of intraoperative cell salvage in off-pump coronary artery bypass grafting

Abstract

Objectives

Cell salvage and retransfusion of autologous blood has been shown to reduce the requirement for homologous blood transfusion during cardiac surgery. The adverse effects of blood transfusion are well-documented. Different techniques have been developed in the past to reduce homologous blood transfusion requirement. We evaluated the advantages of cell saver processed red blood cells which were to be used as autologous blood transfusion intra operatively and tried to avoid allogenic blood transfusion. We studied the safety and efficacy of this technique and determined the effects on haematological parameters, clotting parameters, homologous blood transfusion requirements, blood loss and postoperative parameters.

Methods

This was a 1-year-long study in which 50 patients undergoing off-pump coronary artery bypass grafting were included. In 25 patients, shed blood was collected in the cell saver reservoir intraoperatively and reinfused after processing, while the remaining 25 patients served as the control group.

Results

The difference between the two groups was significant for transfusion need. Moreover, the cell saver was cost effective when compared with the cost of homologous blood transfusion and the complications occurring after homologous blood transfusion.

Conclusion

We believe that autologous cell saver blood transfusion is safe and results in a significant reduction in homologous transfusion whilst not causing a clinically significant coagulopathy. We therefore conclude that autotransfusion is safe and effective in off-pump coronary artery bypass grafting.

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