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July 1973, Vol 107, No. 1 >
ARTICLE | July 1973

Intraoperative Autotransfusion in Abdominal Aortic Resections FREE

Bruce J. Brener, MD; Jeffrey K. Raines, PhD; R. Clement Darling, MD
[+] Author Affiliations

Accepted for publication March 13, 1973.

Reprint requests to 3 Hawthorne Pl, Boston 02114 (Dr. Darling).


Arch Surg. 1973;107(1):78-84. doi:10.1001/archsurg.1973.01350190066017
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Comments

Ten patients with abdominal aortic aneurysms and ten with aortoiliac occlusive disease underwent aortic resections with use of intraoperative autotransfusion. Results were compared with 20 similar patients in whom conventional transfusion techniques were used. An average of 1.5 liters of blood was aspirated, filtered, and reinfused per patient; half of the patients received no homologous blood during surgery. Hematocrit level fell, and free plasma hemoglobin was transiently elevated in all patients. Despite the potential alterations in clotting factors and blood elements, intraoperative autotransfusion appeared to be useful in providing a hepatitisfree, readily available source of blood during difficult aortic resections.

REFERENCES

1 +
Highmore W:  Practical remarks on an overlooked source of blood-supply for transfusion in post-partum hemorrhage . Lancet 1:89, 1874;.
2 +
Duncan J:  On reinfusion of blood in primary and other amputations . Br Med J 1:192-193, 1886;.
3 +
Theis HJ:  Zur behandlung der extrauteringraviditat . Zentralbl Gynaekol 38:1191-1193, 1914;.
4 +
Lockwood CD:  Surgical treatment of Banti's disease: Report of three cases . Surg Gynecol Obstet 25:188-191, 1917;.
5 +
Davis LE, Cushing H:  Experiences with blood replacement during or after major intra-cranial operations . Surg Gynecol Obstet 40:310-322, 1925;.
6 +
Dyer RH Jr:  Intra-operative autotransfusion: A preliminary report and new method . Am J Surg 112:874-878, 1966;.
7 +
Wilson JD, Taswell HF:  Autotransfusion: historical review and preliminary report on a new method . Mayo Clin Proc 43:26-35, 1968;.
8 +
Klebanoff G, Watkins D:  A disposable autotransfusion unit . Am J Surg 116:475-476, 1968;.
9 +
Griswald RA, Ortner AB:  The use of autotransfusion in surgery of the serous cavities . Surg Gynecol Obstet 77:167-177, 1943;.
10 +
Stager WF:  Blood conservation by autotransfusion . Arch Surg 63:78-82, 1951;.
11 +
Klebanoff G:  Early clinical experience with a disposable unit for the intraoperative salvage and reinfusion of blood loss (intra-operative autotransfusion) . Am J Surg 120:718-722, 1970;.
12 +
Klebanoff G: An experience of 100 cases of intra-operative autotransfusion with a commercially available device. Read before the 25th meeting of the American Association of Blood Banks, Washington, DC, Aug 28, 1972.
13 +
Klebanoff G, Phillips J, Evans W:  Use of a disposable autotransfusion unit under varying conditions of contamination: Preliminary report . Am J Surg 120:351-354, 1970;.
14 +
Bennett SH, Hoye RC, Riggle GC:  Intra-operative autotransfusion: Preliminary report of a new blood suction device for anticoagulation of autologous blood . Am J Surg 123:257-260, 1972;.
15 +
Klebanoff G, et al:  Repair of suprahepatic caval laceration employing autotransfusion: An experimental model to demonstrate the effectiveness of intra-operative blood salvage under conditions of massive hemorrhage . J Trauma 12:422-424, 1972;.
16 +
Dorang L, Klebanoff G, Kemmerer WT:  Autotransfusion in long segment spinal fusion . Am J Surg 123:686-688, 1972;.
17 +
Darling RC:  Ruptured arteriosclerotic abdominal aortic aneurysms: A pathologic and clinical study . Am J Surg 119:397-401, 1970;.
18 +
Duncan WC, Linton RR, Darling RC:  Aorto-ilio-femoral atherosclerotic occlusive disease: Comparative results of endarterectomy and Dacron bypass grafts . Surgery 70:974-984, 1971;.
19 +
Swank RL:  Alteration of blood on storage: Measurement of adhesiveness of "aging" platelets and leukocytes and their removal by filtration . N Engl J Med 265:728-733, 1961;.
20 +
McNamara JJ, Burran EL, Suehiro G:  Effective filtration of banked blood . Surgery 71:594-597, 1972;.
21 +
Ashmore PG, et al:  Effect of Dacron wool filtration on the microembolic phenomenon in extracorporeal circulation . J Thorac Cardiovasc Surg 63:240-248, 1972;.
22 +
Connell RS, Swank RL:  Pulmonary microembolism after blood transfusion: An electron microscopic study . Ann Surg 177:40-50, 1973;.
23 +
DeWeese JA, Blaisdell W, Foster J:  Optimum resources for vascular surgery . Arch Surg 105:948-961, 1972;.
24 +
Huggins CE:  Frozen blood . Eur Surg Res 1:3-12, 1969;.
25 +
Langston HT, Milles G, Dalessandro W:  Further experiences with autogenous blood transfusions . Ann Surg 158:333-337, 1963;.
26 +
Cuello L, et al:  Autologous blood transfusion in thoracic and cardiovascular surgery . Surgery 62:814-818, 1967;.
27 +
Newman MM, Hamstra R, Block M:  Use of banked autologous blood in elective surgery . JAMA 218:861-863, 1971;.
28 +
Hallowell P, et al:  Transfusion of fresh autologous blood in open heart surgery: A method for reducing bank blood requirements . J Thorac Cardiovasc Surg 64:941-948, 1972;.
29 +
Relihan M, Olsen RE, Litwin MS:  Clearance rate and effect on renal function of stroma-free hemoglobin following renal ischemia . Ann Surg 176:700-704, 1972;.
30 +
McCaughan JS, et al:  The use of a totally occlusive pump as a flowmeter with observation of hemolysis caused by occlusive and non-occlusive pumps and other pump-oxygenator components . Surgery 44:210-219, 1958;.
31 +
Stewart JW, Sturridge MF:  Hemolysis caused by tubing in extracorporeal circulation . Lancet 1:340-342, 1959;.
32 +
Anderson MW, Kuchiba K:  Blood trauma produced by pump oxygenators . J Thorac Cardiovasc Surg 57:238-244, 1969;.
33 +
Hoye RC, et al:  Fluid volume and albumin kinetics occurring with major surgery . JAMA 222:1255-1261, 1972;.
34 +
Bernstein EF, et al:  Sublethal damage to the red blood cell from pumping . Circulation 35( (suppl 1) ):226-231, 1967;.
35 +
Symbas PN:  Autotransfusion from hemothorax: Experimental and clinical studies . J Trauma 12:689-695, 1972;.

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1 +
Highmore W:  Practical remarks on an overlooked source of blood-supply for transfusion in post-partum hemorrhage . Lancet 1:89, 1874;.
2 +
Duncan J:  On reinfusion of blood in primary and other amputations . Br Med J 1:192-193, 1886;.
3 +
Theis HJ:  Zur behandlung der extrauteringraviditat . Zentralbl Gynaekol 38:1191-1193, 1914;.
4 +
Lockwood CD:  Surgical treatment of Banti's disease: Report of three cases . Surg Gynecol Obstet 25:188-191, 1917;.
5 +
Davis LE, Cushing H:  Experiences with blood replacement during or after major intra-cranial operations . Surg Gynecol Obstet 40:310-322, 1925;.
6 +
Dyer RH Jr:  Intra-operative autotransfusion: A preliminary report and new method . Am J Surg 112:874-878, 1966;.
7 +
Wilson JD, Taswell HF:  Autotransfusion: historical review and preliminary report on a new method . Mayo Clin Proc 43:26-35, 1968;.
8 +
Klebanoff G, Watkins D:  A disposable autotransfusion unit . Am J Surg 116:475-476, 1968;.
9 +
Griswald RA, Ortner AB:  The use of autotransfusion in surgery of the serous cavities . Surg Gynecol Obstet 77:167-177, 1943;.
10 +
Stager WF:  Blood conservation by autotransfusion . Arch Surg 63:78-82, 1951;.
11 +
Klebanoff G:  Early clinical experience with a disposable unit for the intraoperative salvage and reinfusion of blood loss (intra-operative autotransfusion) . Am J Surg 120:718-722, 1970;.
12 +
Klebanoff G: An experience of 100 cases of intra-operative autotransfusion with a commercially available device. Read before the 25th meeting of the American Association of Blood Banks, Washington, DC, Aug 28, 1972.
13 +
Klebanoff G, Phillips J, Evans W:  Use of a disposable autotransfusion unit under varying conditions of contamination: Preliminary report . Am J Surg 120:351-354, 1970;.
14 +
Bennett SH, Hoye RC, Riggle GC:  Intra-operative autotransfusion: Preliminary report of a new blood suction device for anticoagulation of autologous blood . Am J Surg 123:257-260, 1972;.
15 +
Klebanoff G, et al:  Repair of suprahepatic caval laceration employing autotransfusion: An experimental model to demonstrate the effectiveness of intra-operative blood salvage under conditions of massive hemorrhage . J Trauma 12:422-424, 1972;.
16 +
Dorang L, Klebanoff G, Kemmerer WT:  Autotransfusion in long segment spinal fusion . Am J Surg 123:686-688, 1972;.
17 +
Darling RC:  Ruptured arteriosclerotic abdominal aortic aneurysms: A pathologic and clinical study . Am J Surg 119:397-401, 1970;.
18 +
Duncan WC, Linton RR, Darling RC:  Aorto-ilio-femoral atherosclerotic occlusive disease: Comparative results of endarterectomy and Dacron bypass grafts . Surgery 70:974-984, 1971;.
19 +
Swank RL:  Alteration of blood on storage: Measurement of adhesiveness of "aging" platelets and leukocytes and their removal by filtration . N Engl J Med 265:728-733, 1961;.
20 +
McNamara JJ, Burran EL, Suehiro G:  Effective filtration of banked blood . Surgery 71:594-597, 1972;.
21 +
Ashmore PG, et al:  Effect of Dacron wool filtration on the microembolic phenomenon in extracorporeal circulation . J Thorac Cardiovasc Surg 63:240-248, 1972;.
22 +
Connell RS, Swank RL:  Pulmonary microembolism after blood transfusion: An electron microscopic study . Ann Surg 177:40-50, 1973;.
23 +
DeWeese JA, Blaisdell W, Foster J:  Optimum resources for vascular surgery . Arch Surg 105:948-961, 1972;.
24 +
Huggins CE:  Frozen blood . Eur Surg Res 1:3-12, 1969;.
25 +
Langston HT, Milles G, Dalessandro W:  Further experiences with autogenous blood transfusions . Ann Surg 158:333-337, 1963;.
26 +
Cuello L, et al:  Autologous blood transfusion in thoracic and cardiovascular surgery . Surgery 62:814-818, 1967;.
27 +
Newman MM, Hamstra R, Block M:  Use of banked autologous blood in elective surgery . JAMA 218:861-863, 1971;.
28 +
Hallowell P, et al:  Transfusion of fresh autologous blood in open heart surgery: A method for reducing bank blood requirements . J Thorac Cardiovasc Surg 64:941-948, 1972;.
29 +
Relihan M, Olsen RE, Litwin MS:  Clearance rate and effect on renal function of stroma-free hemoglobin following renal ischemia . Ann Surg 176:700-704, 1972;.
30 +
McCaughan JS, et al:  The use of a totally occlusive pump as a flowmeter with observation of hemolysis caused by occlusive and non-occlusive pumps and other pump-oxygenator components . Surgery 44:210-219, 1958;.
31 +
Stewart JW, Sturridge MF:  Hemolysis caused by tubing in extracorporeal circulation . Lancet 1:340-342, 1959;.
32 +
Anderson MW, Kuchiba K:  Blood trauma produced by pump oxygenators . J Thorac Cardiovasc Surg 57:238-244, 1969;.
33 +
Hoye RC, et al:  Fluid volume and albumin kinetics occurring with major surgery . JAMA 222:1255-1261, 1972;.
34 +
Bernstein EF, et al:  Sublethal damage to the red blood cell from pumping . Circulation 35( (suppl 1) ):226-231, 1967;.
35 +
Symbas PN:  Autotransfusion from hemothorax: Experimental and clinical studies . J Trauma 12:689-695, 1972;.

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