The influence of autotransfusion on homologous blood requirements during aortic reconstruction.

To evaluate the influence of intraoperative autotransfusion with the Haemonetics Cell Saver on homologous blood requirement during abdominal aortic reconstruction, 707 patients were evaluated retrospectively. The preautotransfusion group consisted of 557 patients who underwent reconstruction for aneurysms or occlusive disease from 1974 to 1978, before the introduction of autotransfusion, whereas the autotransfusion group consisted of 150 patients who underwent similar procedures from 1980 to 1981, after the introduction of autotransfusion. The preautotransfusion patients required a mean total volume of 5.9 units of homologous blood, with 5.0 units given intraoperatively. In comparison, the autotransfusion patients required a mean total volume of only 3.0 units of bank blood, with 1.7 units given intraoperatively (P = 0.000). The autotransfusion group received a mean volume of 1,068 cc of autologous, salvaged blood per operation. The overall incidence of postoperative complications was 19.7% in the preautotransfusion group and 11.4% in the autotransfusion group (P = 0.017). Operative mortality was 5.6% in the preautotransfusion group and 2.7% in the autotransfusion group (P = 0.146). Intraoperative autotransfusion effectively reduces the volume of bank blood required by patients undergoing abdominal aortic reconstruction without a measurable increase in mortality or morbidity.