EFFECTIVENESS OF AUTOLOGOUS BLOOD-TRANSFUSION IN PATIENTS UNDERGOING RADICAL HYSTERECTOMY

Autologous blood transfusion (ABT) is a safe and useful procedure in p atients undergoing elective surgery, but it has not been recommended f or radical hysterectomy with pelvic lymphadenectomy. We retrospectivel y evaluated the results of an ABT programme in 146 consecutive women u ndergoing radical hysterectomy and pelvic lymphadenectomy for cervical carcinoma at our institution. Forty women underwent autologous blood transfusion after predeposit; 23 underwent preoperative normovolemic h aemodilution; 38 were eligible but could not receive autologous blood transfusion for logistic reasons; 45 were excluded for medical reasons . 126 units of blood were collected, of which 100 (80 %) were reinfuse d. The donation procedure was well-tolerated and no transfusion reacti on was observed. Homologous blood transfusion was needed in 13 % of pa tients receiving predeposit or haemodilution (8/63), in 42 % of patien ts that were eligible but not receiving autologous blood transfusion ( 16/(38), and in 71 % of non-eligible patients (32/45). The total numbe r of units of homologous blood required for transfusion was lower in p atients undergoing predeposit or haemodilution (14) than in those incl uded in the observation arm (43). Autologous blood transfusion is a sa fe practice which greatly reduces the need for homologous blood transf usion, and radical hysterectomy with pelvic lymphadenectomy represents an adequate indication for this procedure, as the majority of deposit ed blood is actually reinfused.