ALLOGENEIC VERSUS AUTOLOGOUS BLOOD DURING ABDOMINAL AORTIC-ANEURYSM SURGERY

Objectives: To determine if cell-salvaged autologous blood can serve a s an alternative to homologous blood, and to examine the incidence of infected complications and length of postoperative stay. Design: A pro spective randomised study comprising autologous and homologous blood t ranfusions in patients undergoing elective infrarenal abdominal aortic surgery. Methods: Fifty patients undergoing AAA surgery were prospect ively randomised to homologous blood (n=27), or autologous blood trans fusion (n = 23), using a cell salvage autotransfusion device. Results: The haemoglobin at the time of hospital discharge uas similar for bot h groups (11.0 vs. 10.8 g/dl) with no difference in perioperative mort ality. The length of stay teas reduced in those patients who received autologous blood (9 days vs. 12 days, p<0.05 Mann-Whitney U test). The re were four infected cases in Nle autologous group and 12 in the homo logous group (p=n.s., Fisher's exact probability test). However, patie nts mile received 3-4 units of homologous blood had an increased risk of infection compared to those who received a similar amount of autolo gous blood (50% vs. 0%). Conclusions: Cell salvage autologous blood ca n safely replace, or at least decrease, exposure to homologous blood t ransfusion, with a reduction in the mean hospital stay.