Document Detail


Impact of intraoperative red blood cell salvage on transfusion requirements and outcomes in radical prostatectomy.
MedLine Citation:
PMID:  19320863     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Preoperative autologous blood donation lowers preoperative hemoglobin (Hb) levels, and the collected blood is frequently wasted. Intraoperative red blood cell (RBC) salvage provides fresher autologous blood in proportion to surgical blood loss, making cell salvage (CS) in radical prostatectomy (RP) feasible for study. STUDY DESIGN AND METHODS: This retrospective study compared two strategies to reduce allogeneic RBC transfusion requirements in RP: preoperative autologous donation (PAD) versus CS. Patients underwent RP by one surgeon at one institution during two comparable time periods in 2005 (PAD-Group 1) and 2006 (CS-Group 2). RESULTS: Group 1 patients (n = 40) underwent PAD, collecting 63 autologous RBC units; 36 units (57.1%) were reinfused and 27 (42.9%) were wasted. No Group 1 patient received allogeneic blood. Group 2 patients (n = 63) underwent intraoperative CS and received a mean of 287 mL of salvaged blood. In Group 2, two patients (3.2%) with preoperative Hb levels too low to permit autologous donation each received 2 units of allogeneic RBCs. Group 1 patients had significantly lower preoperative (-1.4 g/dL) and postoperative (-0.8 g/dL) Hb values compared to the CS group. There were no significant differences between groups in procedure times, length of stay, or numbers of cancer recurrences over the 24- to 36-month follow-up period. CONCLUSION: Perioperative CS can effectively replace PAD for RP patients, offering similar avoidance of allogeneic transfusion, with greater convenience and superior postoperative Hb levels.
Authors:
Duncan MacIvor; Joel Nelson; Darrell Triulzi
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Publication Detail:
Type:  Journal Article     Date:  2009-03-20
Journal Detail:
Title:  Transfusion     Volume:  49     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-15     Completed Date:  2009-07-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1431-4     Citation Subset:  IM    
Affiliation:
Department of Pathology and Laboratory Medicine, University of Kentucky Medical Center, 800 Rose Street, Lexington, KY 40536, USA. dma223@email.uky.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Loss, Surgical
Blood Transfusion, Autologous
Erythrocyte Transfusion / methods*
Humans
Male
Middle Aged
Prostatectomy*
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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