Effect of perioperative blood transfusion and cell saver on the incidence of postoperative infective complications in patients with an aneurysm of the abdominal aorta.

OBJECTIVE: To find out if there was an association between perioperative blood transfusion and the development of infective complications, and whether the use of the cell saver for autologous transfusion had any influence. DESIGN: Retrospective study. SETTING: University Hospital. SUBJECTS: 102 consecutive patients who had been operated on for aneurysms of the abdominal aorta. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: 32 of the 102 patients developed infective complications. Thirteen patients died (six after emergency and seven after elective operations). Nine died as a direct result of infection, one of intra-abdominal bleeding, one of necrosis of the colon, and two of cardiopulmonary complications. The incidence of infective complications was directly related to the number of units of blood transfused, being 0 when 0 or 1 was given; 11 (20%) when 2-4 units were given; 12 (55%) when 5-8 units were given; and 9 (69%) when the number was 9 or more. The cell saver had no influence on the incidence. Other factors associated with higher rates of infective complications were the insertion of a bifurcated prosthesis (p = 0.03), and emergency operation (p < 0.001). CONCLUSION: These results confirm the association between blood transfusion and the incidence of infective complications. It may be that more intensive use of the cell saver and preoperatively saved autologous blood could reduce the rate of infective complications.