PERIOPERATIVE AUTOTRANSFUSION - A DECISIV E PROGRESS IN VASCULAR-SURGERY

There are two different methods of autotransfusion during an operation ;one without blood washing and the other with wash red cells obtained after the filtering and concentration of the recovered blood. The firs t method has the advantage of being simple and cheap while recovering 1500-2000 ml of blood. Nevertheless it is insufficiant in the case of an important or rapid bleeding. The weight of haemoglobin in the recov ered blood is relatively low and the hemolysis is without clinical con sequences. The rate of the coagulation factors is reduced. The autotra nsfusion with wash red cells requires a more important investment at t he beginning. But the washing process eliminates the cell micro-aggreg ates and nearly all of the substances in the recovered blood. Therefor e concentrated units of red cells may be obtained with hematocrits bet ween 45 and 65 %. Autotransfusion with washing offers a greater securi ty when the bleeding is important or violent. The autotransfusion is u seful For a bleeding between 1 and 3 litres. The average volume recove red corresponds to 2.5 pockets of blood extract, thus covering the cos ts for the kits. II the bleeding exceeds 1.5 times the blood volume, b lood extract and plasma will be required in addition. The risk of homo logue blood transfusion can only increase the development of autotrans fusion techniques and particulary the recovery of blood during the ope ration process (J Mal Vasc 1996; 21, Suppl. A: pages 13-21).