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Transfusion of post-operative shed blood: laboratory characteristics and clinical utility

European Spine Journal volume 13, pages S107–S113 (2004)Cite this article

Abstract

Increased awareness of the potential hazards of allogenic blood transfusion, such as incompatibility reactions, metabolic and immunologic disorders, or transmission of viral diseases, has led to an emphasis on allogeneic blood alternatives. For orthopaedic surgery, several autologous transfusion modalities have emerged as alternatives to allogeneic blood transfusion, avoiding its immunomodulatory effects. Among them, transfusion or return of post-operative salvaged shed blood has become popular in major orthopaedic procedures. However, although the effectiveness of this blood-saving method is well documented, several authors have questioned its safety and recommended the use of washed blood. Therefore, this review analyses the haematologic characteristics of unwashed filtered shed blood, including metabolic status and survival of red blood cells, the components of the haemostatic system, the content of fat particles, bacterial and tumour cells and the possibility of their removal, the content of inflammatory mediators, and the effects on the patient’s immune system. From data reviewed in this paper, it can be concluded that post-operative salvage of blood seems to be an excellent source of functional and viable red cells without many of the transfusion-related risks and with some immuno-stimulatory effects. In addition, from our experience, post-operative re-infusion of unwashed shed blood after major spine procedures has proved to reduce post-operative homologous transfusion requirements and to complement pre-operative autologous blood donation, without any clinically relevant complication.

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Author information

Affiliations

  1. Department of Biochemistry and Molecular Biology, School of Medicine, University of Málaga, Málaga, Spain

    M. Muñoz & J. J. García-Vallejo

  2. Department of Haematology, H.R.U. Carlos Haya, Málaga, Spain

    M. D. Ruiz

  3. Department of Orthopaedic Surgery, Parque San Antonio Hospital, Málaga, Spain

    R. Romero, E. Olalla & C. Sebastián

  4. GIEMSA, Facultad de Medicina, Universidad de Málaga, Campus de Teatinos, s/n 29071, Málaga, Spain

    M. Muñoz

Authors
  1. M. Muñoz
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  2. J. J. García-Vallejo
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  3. M. D. Ruiz
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  4. R. Romero
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  5. E. Olalla
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  6. C. Sebastián
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Corresponding author

Correspondence to M. Muñoz.

Additional information

GIEMSA (International Multidisciplinary Autotransfusion Study Group). The authors acknowledge the financial support to GIEMSA from Fondo de Investigaciones Sanitarias, Instituto Carlos III, Spain ( FIS PI02/1826) and Junta de Andalucía, Spain (I+D Group CTS-0189).

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Muñoz, M., García-Vallejo, J.J., Ruiz, M.D. et al. Transfusion of post-operative shed blood: laboratory characteristics and clinical utility. Eur Spine J 13, S107–S113 (2004). https://doi.org/10.1007/s00586-004-0718-0

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  • DOI: https://doi.org/10.1007/s00586-004-0718-0

Keywords

  • Post-operative salvaged blood
  • Spine surgery
  • Fat particles
  • Cytokines
  • Coagulation
  • Immune system
  • Effectiveness