Autotransfusion—Safe at Any Speed?

Arch Surg. 1974;108(6):761. doi:10.1001/archsurg.1974.01350300005001.
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Intraoperative autotransfusion has great appeal; with the rationing of our natural resources a short step away, its reintroduction is timely. However, as Drs. Aaron, Beazley, and Riggle point out (see page 831), the "blood" that is readied for reinfusion differs both from the "blood" that is shed and from the "blood" preserved in the bank.

Several questions raised by this article have plagued us as we have reviewed our experience.

First, are red cells preserved or destroyed? Clearly, the technique of aspiration is traumatic, and hemolysis is quite striking. For example, we found that red cell mass as determined by chromium labeling studies was reduced by approximately 50% in five patients who received an average of 4.5 liters of autotransfused blood during aortic resections.

Second, do platelets function properly? As the authors point out, aggregates appear in the aspirated blood. Some of these particles are undoubtedly macroaggregates, such as fat


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