Intraoperative blood salvage

Intraoperative blood salvage
Intervention
ICD-9	99.00
MeSH	D057725
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Intraoperative blood salvage, also known as autologous blood transfusion or cell salvage, is a medical procedure involving recovering blood lost during surgery and re-infusing it into the patient. It is a major form of autotransfusion.

It has been used for many years and gained greater attention over time as risks associated with allogenic (separate-donor) blood transfusion have seen greater publicity and more fully appreciated. Several medical devices have been developed to assist in salvaging the patient's own blood in the perioperative setting. These are used frequently in cardiothoracic and vascular surgery, in which blood usage has traditionally been high. With a greater effort to avoid adverse events due to transfusion there has also been an emphasis on blood conservation (see bloodless surgery).

Providing safe blood for transfusion remains a challenge despite advances in preventing transmission of hepatitis B, hepatitis C, AIDS/HIV, West Nile virus (WNV), and transfusion-transmitted bacterial infection. Human errors such as misidentifying patients and drawing blood samples from the wrong person present much more of a risk than transmissible diseases.

Additional risks include transfusion related acute lung injury (TRALI), a potentially life-threatening condition with symptoms such as dyspnea, fever, and hypotension occurring within hours of transfusion, and also transfusion-associated immunomodulation, which may suppress the immune response and cause adverse effects such as a small increase in the risk of postoperative infection.

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