Intraoperative autotransfusion for repair of unruptured aneurysms of the infrarenal abdominal aorta - A multicenter study of 203 patients

Background, The goals of this study were to evaluate the costs and savings of intra- and postoperative blood transfusions as well as the potential bio logical modifications associated with the use of intraoperative blood salva ge. Methods. Intraoperative autotranfusion (IOAT) with wash-out was prospec tively studied during the repair of unruptured aneurysms of infrarenal abdo minal aorta in 203 patients operated on in 13 institutions. Results. The me an quantity of blood retrieved was 688 +/- 468 ml. The mean quantity of blo od derivatives and intraoperative solutes used for repletion was 4261 ml, r anging from 1723 ml between days 0 to D2 to 562 ml from D3 to D8, Ninety-ei ght patients did not receive any blood derivatives at all. Thirty-five pati ents received plasma to correct coagulation factors. The quantity of autotr ansfused globular concentrate was less than 500 ml in 89 patients, Conclusi ons. IOAT precluded the need for transfusion of homologous globular concent rates, particularly in those patients who had bled most. On average, more t han two globular concentrates mere recuperated. Use of IOAT led to financia l savings. Perioperative bleeding is not the only factor that intervenes in the decision to transfuse globular concentrates. Postoperative dilution is the most important factor as attested by the amount of protides and the he matocrit. Coagulation factors are modified but remain compatible with norma l hematosis in 83% of patients undergoing operation.