Abstract

Background: In this study, we aimed to investigate the effect of using autologous blood recovery systems on transfusion-related complications in patients undergoing lung transplantation and cardiovascular surgeries.

Methods: Between May 2016 and May 2019, a total of 104 patients (90 males, 14 females; mean age: 59.3±16.4 years; range, 12 to 89 years) in whom cell-saver and autologous blood recovery systems were used during lung transplantation or cardiovascular surgeries were retrospectively analyzed. The patients were divided into two groups as Group 1 (n=61) consisting of patients who received autologous blood transfusion and as Group 2 (n=43) consisting of patients who did not. Data including demographic and clinical characteristics of the patients, operation data, and postoperative complications were recorded.

Results: The total amount of transfused blood/blood product was found to be significantly higher in Group 1 (p=0.018). However, transfusionrelated complications were found to be higher in Group 2 (p=0.0261). There was no significant difference in the length of hospital stay between the groups.

Conclusion: Autologous blood transfusion may prevent the development of transfusion-related complications by reducing the amount of allogenic transfusion in major surgical procedures. In our study, the autologous blood transfusion was used in critical patients with major bleeding and, therefore, the total amount of transfused blood/blood product was higher in these patients. Nevertheless, lower complication rates in this patient group emphasize the importance of autologous blood transfusion.

Early/late complications may occur during blood and blood product transfusions, despite all the tests carried out and the current precautions taken in this regard. In addition to these complications, there may be several issues to resolve, such as limited numbers of donors, transfusion-related infections and high costs.[1,2] Such issues may become more important in operations requiring the use of large quantities of blood/blood product, such as cardiac surgery and organ transplants.[1-4]

Autologous blood recovery systems (ABRS), which allow the reinfusion of the blood lost by the patient during surgery through dedicated systems, are an important step forward in the efforts to overcome such issues. These systems have been shown to be safe and to reduce the need for allogenic blood transfusions, particularly in cases of general surgery, orthopedics, gynecology, and cardiovascular surgery.[3-8] These systems are also helpful to overcome the transfusion-related reactions related to blood bank products replacement.[3-8] Similar systems have also shown their ability to reduce the need for allogenic transfusions during liver and heart transplantations.[2,6] Considering these studies, we hypothesized that autologous blood transfusion (ABT) systems might be also of benefit during lung transplant (LTx) operations and would reduce the blood bank products replacement and associated complications in these patients. In this study, therefore, we aimed to investigate the effect of using ABRS on transfusion-related complications in patients undergoing lung transplantation and cardiovascular surgeries requiring massive transfusion.