Peroperative autotransfusion in aortic surgery

: Intraoperative autotransfusion of blood by means of a Solcotrans retransfusion bag was used during abdominal aortic surgery in a series of 25 patients. The need for transfusion of blood products, erythrocytes and plasma, decreased from 8.5 units to 4.5, as compared with 26 patients operated during the same period the preceding year (p less than 0.01). Hemoglobin was not lower at any point per- or postoperatively when autotransfusion was used. In contrast to one out of 26 patients operated without autotransfusion (p less than 0.05), seven of 25 patients whose operations involved autotransfusion did not need any donor transfusions. Exposure to potentially contagious donor products may be further decreased by using polygeline (Haemmaccel), and in some cases heat-treated albumin, in stead of plasma. While the mean number of donor transfusions remained relatively high with autotransfusion, the median number of erythrocyte donor transfusions was 0 units preoperatively and one unit postoperatively. An average of 684 ml of blood was retransfused. This corresponds to less than two units of blood. The main decrease in the number of transfusions was due to more careful surgical technique, the use of impregnated vascular grafts, and a changed attitude towards transfusions.