For patients who cannot donate their own blood in advance of surgery, but still prefer to avoid transfusions of donor blood, there is a process called surgical blood salvage which also allows a patient to be transfused with his or her own blood. Salvaging blood lost during surgery is also called “autotransfusion” or “cell salvage.”

How Surgical Blood Salvage Works

Surgical blood salvage systems collect the blood that a patient loses during or after the surgery, clean it, and make it available for transfusion back to the patient. All of the processing of the blood is done with a sterile, plastic kit. The blood is never exposed to outside air, and the plastic kit is discarded after the surgery.

With surgical blood salvage, a suction wand is applied next to the patient’s incision site during surgery. The wand sucks the blood away from the incision, through tubing, and into a centrifuge bowl. Automated processing of the blood in the centrifuge bowl cleans the blood of irrigating solutions and other undesirable materials that are by-products of the surgical procedure. The cleaned blood, still in the centrifuge bowl, is washed with a solution of salt water and then transferred to a blood bag so that it is ready for transfusion back to the patient. All of this processing occurs in the sterile, plastic kit described above.

The Cell Saver® System

The Cell Saver system is a surgical blood salvage system designed to meet the needs of the cardiovascular, trauma, and transplant patients. It can salvage blood in high blood loss surgeries.

The OrthoPAT® System

The OrthoPAT system is the first and only surgical blood salvage system designed to meet the specific needs of the orthopedic surgery patient and medical team. It can salvage blood lost both during and after the orthopedic surgery. It can adjust to the needs of the orthopedic surgical patient who tend to bleed more slowly, bleed less, and bleed for some time after surgery.

The cardioPAT™ System

The cardioPAT system is the first and only surgical blood salvage system designed to meet the needs of any cardiovascular surgery. It can salvage blood lost both during and after the surgery and process lower volumes of blood loss. (The cardioPAT system is currently in limited market release in the U.S. and Europe. It will be available for all patients by the end of calendar 2005.)

Is Surgical Blood Salvage Right for You?

The decision to use a surgical blood salvage device and reinfuse a patient’s blood is entirely within the domain of the medical team. The following recommendations are based upon generally accepted medical practice regarding surgical blood salvage.

Surgical blood salvage is indicated for patients who meet at least one of the following criteria:

• The patient is expected to lose sufficient blood during or after the surgery so as to require a transfusion, and surgical blood salvage will likely reduce or eliminate the need for a transfusion of donor blood.
• Religious beliefs cause the patient to refuse a transfusion of donor blood, but accept a transfusion of his/her own blood.
• Compatible donor blood is not available.
• The patient is unable to donate sufficient quantities of his/her blood prior to surgery to adequately cover the anticipated transfusion requirement.
• The patient or physician prefers surgical blood salvage rather than preoperative donation or transfusion of donor blood.

Surgical blood salvage is generally contraindicated in the following circumstances:

• The patient has a systemic infection.
• Blood salvaged from the surgical field is contaminated by bacteria from an active infection at the wound or drain site.
• There are malignant cells mixed with the blood salvaged from the surgical field.
• There is prostatic fluid or amniotic fluid mixed with the blood salvaged from the surgical field.
• The collected blood contains certain topical hemostatic agents, anti-bacterial agents or wound irrigants that may damage red blood cells or are inappropriate for infusion.

Decisions about blood transfusion, like all medical decisions, should be made in consultation with your personal physician. Your physician can provide additional information. Other resources on blood transfusion issues include:

The American Association of Blood Banks: www.aabb.org