A Comparative Study Of Autologous Versus Homologous Blood Transfusion During General Surgery

10.5580/1333 ◽  
2009 ◽  
Vol 19 (2) ◽  
Keyword(s):  
Blood Transfusion ◽  
Comparative Study ◽  
General Surgery ◽  
Homologous Blood ◽  
Homologous Blood Transfusion

These studies indicate that homologous blood transfusion affects the outcome of clinical diseases in both beneficial and adverse ways. Experimental situations are not suitable for randomized clinical trials - transfusions cannot be given to prevent the onset of diabetes or wound strength measured in man following receipt of homologous or autologous blood. These experimental observations indicate that the outcomes of numerous clinical diseases which have not been studied may be manipulated by the use of homologous blood or that transfusion should be avoided. Several studies indicate that changes in immune function following transfusion are permanent. The number of clinical phenomena associated with immune suppression and attributable to blood transfusion is unknown. SUMMARY Given the evidence presented here it would be foolish to suggest that transfusion of homologous blood has no immunologic consequences for the recipient. Blood transfusion is the oldest form of transplant - no one would argue that transplantation between unrelated individuals has no influience on the immune system. In organ transplantation the immunologic sequelae are permanent and there is evidence that the same is true following homologous blood transfusion. Lymphocytopenia is present one year following surgery for Crohn's disease if patients receive perioperative blood transfusion (43). Colorectal cancer patients transfused more than seven years prior to diagnosis have significantly reduced numbers of lymphocytes and lower natural killer cytotoxicity than colorectal cancer patients who have never been transfused (44). Transfusion of neonates causes suppression of lymphocyte reactivity which is still demonstrable 25 to 30 years later (45). There is evidence that transfusion at any time prior to elective surgery increases susceptibility to infectious complications (14) and otherwise healthy transfused individuals may be at increased risk of developing malignancies (46). All the longterm consequences of blood transfusion are not negative: Survival of transplants is prolonged by pretransplant transfusion and some women suffering from recurrent spontaneous abortion can deliver at term if previously transfused with their spouse's leukocytes. In the future we will be able to transfuse blood without causing immune perterbations and the consequent clinical phenomena. Studies presented here suggest that removal of donor leukocytes reduces the risk of infection and cancer recurrence. The technology has not reached the point of reducing the leukocyte number in transfused blood below 10^/unit. An alternative which is increasingly being utilized is autologous blood programs. Physicians are discovering that patients tolerate hemoglobin levels which were previously unacceptably low and many patients prefer being anemic over the risks of receiving homologous blood. Since transfusion is an identifier of high cost hospitalized patients, alternatives to routine blood use are being studied in hopes of safely reducing the costs of transfusion. REFERENCES 1. Jubert AV, Lee ET, Hersh EM, McBride CM. J Surg Res 15:399-403, 1973. 2. M 19 u4n ( s3t ) e3r4A6-M 35 , 2 W , i1n9c8h1u . rch RA, Keane RM, Shatney CH, Ernst CB, Nuidema GD. Ann Surg

1995 ◽  
pp. 300-300
Keyword(s):  
Colorectal Cancer ◽  
Blood Transfusion ◽  
Cancer Patients ◽  
Randomized Clinical Trials ◽  
Elective Surgery ◽  
Autologous Blood ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
One Year ◽  
Colorectal Cancer Patients

scholarly journals Decreasing the Blood Transfusion Rate in Elective Hip Replacement Surgery Using an Autologous Drainage System

2007 ◽  
Vol 89 (2) ◽  
pp. 136-139 ◽  
Author(s):  
SW Sturdee ◽  
DJ Beard ◽  
G Nandhara ◽  
SV Sonanis
Keyword(s):  
Blood Transfusion ◽  
Hip Replacement ◽  
Drainage System ◽  
Length Of Hospital Stay ◽  
Transfusion Rate ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
Drain Group ◽  
The Mean ◽  
Arthroplasty Surgery

INTRODUCTION This is a prospective study looking at the effectiveness of autologous postoperative drains in primary uncemented total hip replacement (THR) surgery. PATIENTS AND METHODS A total of 86 patients were studied, with 43 using standard suction drains (normal drain group) and 43 using autologous drains (autologous drain group). RESULTS Thirty-seven units of homologous blood were transfused in the normal drain group and 5 units in the autologous drain group. The mean number of units of homologous blood transfused per patient was reduced from 0.86 to 0.12 (P < 0.01) with the use of autologous drains and the transfusion rate was reduced from 23% to 6% (P < 0.02). The mean length of hospital stay was also reduced by two nights (P < 0.05). There were no adverse effects from using the autologous system and it does reduce the need for a homologous blood transfusion. CONCLUSIONS The system is simple and easy to use and we have also found it to be cost effective. Previously, it has not been reported as being effective in hip arthroplasty surgery, unlike knee arthroplasty surgery. We would recommend using autologous postoperative drains in primary THR surgery.

Perioperative Homologous Blood Transfusion and Survival in Patients with Surgically Treated Renal Cell Carcinoma

UroOncology ◽  
2003 ◽  
Vol 3 (1) ◽  
pp. 23-25 ◽  
Author(s):  
Wilmosh Mermershtain ◽  
Igor Eidelberg ◽  
Igor Yusim ◽  
Shmuel Ariad ◽  
Jacob Kaneti
Keyword(s):  
Renal Cell Carcinoma ◽  
Blood Transfusion ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Homologous Blood ◽  
Homologous Blood Transfusion

scholarly journals Frequency of homologous blood transfusion in patients undergoing cleft lip and palate surgery

2010 ◽  
Vol 43 (01) ◽  
pp. 054-059
Author(s):  
Wasiu L. Adeyemo ◽  
Mobolanle O. Ogunlewe ◽  
Ibironke Desalu ◽  
Akinola L. Ladeinde ◽  
Titilope A. Adeyemo ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Cleft Palate ◽  
Teaching Hospital ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
University Teaching ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
The Mean

ABSTRACT Aim: The study aims to determine the frequency of homologous blood transfusion in patientsundergoing cleft lip and palate surgery at the Lagos University Teaching Hospital, Nigeria. Setting and Design: A prospective study of transfusion rate in cleft surgery conducted at the Lagos University Teaching Hospital, Nigeria. Material and Methods: One hundred consecutive patients who required cleft lip and palate surgery were recruited into the study. Data collected included age, sex and weight of patients, type of cleft defects, type of surgery done, preoperative haematocrit, duration of surgery, amount of blood loss during surgery, the number of units of blood cross-matched and those used. Each patient was made to donate a unit of homologous blood prior to surgery. Results: There were 52 females and 48 males with a mean age of 64.4 ± 101.1 months (range, 3-420 months). The most common cleft defect was isolated cleft palate (45%) followed by unilateral cleft lip (28%). Cleft palate repair was the most common procedure (45%) followed by unilateral cleft lip repair (41%). The mean estimated blood loss was 95.8 ± 144.9 ml (range, 2-800ml). Ten (10%) patients (CL=2; CP=5, BCL=1; CLP=2) were transfused but only two of these were deemed appropriate based on percentage blood volume loss. The mean blood transfused was 131.5 ± 135.4ml (range, 35-500ml). Six (60%) of those transfused had a preoperative PCV of < 30%. Only 4.9% of patients who had unilateral cleft lip surgery were transfused as compared with 50% for CLP surgery, 11% for CP surgery, and 10% for bilateral cleft lip surgery. Conclusions: The frequency of blood transfusion in cleft lip and palate surgery was 10% with a cross-match: transfusion ratio of 10 and transfusion index of 0.1. A “type and screen” policy is advocated for cleft lip and palate surgery.

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