Clinical evaluation of autotransfusion during liver transplantation

Y. Kang, S. Aggarwal, M. Virji, A. W. Pasculle, J. H. Lewis, Judith (Judy) Freeman, L. K. Martin

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

The clinical suitability of intraoperative autotransfusion was evaluated in 25 patients undergoing orthotopic liver transplantation using a Cell Saver 4 (Haemonetics) with acid-citrate-dextrose anticoagulation. In the first 14 patients (phase 1), biochemical, hematologic, coagulation, and semiquantitative bacteriologic studies were performed from the collected blood, processed blood, and patients' blood before and after 500 mL of autotransfusion. The acid citrate-dextrose solution produced adequate anticoagulation, and the system effectively removed most of the potassium, red blood cell fragments, plasma free hemoglobin, bilirubin, coagulation factors, platelets, and fibrin degradation products. Autotransfusion (500 mL) did not alter coagulation, electrolyte balance, and hematologic findings in recipients except for a clinically insignificant increase in plasma free hemoglobin. Seventeen of 56 samples of the collected blood or processed blood were positive for coagulase (-) Staphylococcus (occasional or rare), but blood cultures before and after autotransfusion were negative inall patients. In the next 11 patients (phase 2), a quantitative bacteriologic study was performed from the collected blood, processed blood, skin, bile duct stump, peritoneal cavity, and room air using a mock reservoir. The processed blood was not transfused. All blood cultures from the patients were sterile. However, coagulase (-) Staphylococcus or Bacillus sp was seen in two cultures from skin, three from the processed blood, and three from air, suggesting that room air and skin were the sources of contamination. When the patients of the two phases of study were compared, postoperative blood cultures were all sterile, and renal function was similar. Therefore, autotransfusion appears to be clinically acceptable during liver transplantation. Occasional contamination by few bacteria appears to be insignificant in patients who receive prophylactic antibiotic therapy.

Original languageEnglish (US)
Pages (from-to)94-100
Number of pages7
JournalAnesthesia and Analgesia
Volume72
Issue number1
StatePublished - 1991
Externally publishedYes

Fingerprint

Autologous Blood Transfusions
Liver Transplantation
Coagulase
Air
Staphylococcus
Skin
Hemoglobins
Fibrin Fibrinogen Degradation Products
Water-Electrolyte Balance
Blood Coagulation Factors
Peritoneal Cavity
Bile Ducts
Bilirubin
Bacillus
Potassium
Blood Platelets
Erythrocytes
Anti-Bacterial Agents
Bacteria
Kidney

Keywords

  • surgery, transplantation - liver
  • transfusions, autotransfusion

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Kang, Y., Aggarwal, S., Virji, M., Pasculle, A. W., Lewis, J. H., Freeman, J. J., & Martin, L. K. (1991). Clinical evaluation of autotransfusion during liver transplantation. Anesthesia and Analgesia, 72(1), 94-100.

Clinical evaluation of autotransfusion during liver transplantation. / Kang, Y.; Aggarwal, S.; Virji, M.; Pasculle, A. W.; Lewis, J. H.; Freeman, Judith (Judy); Martin, L. K.

In: Anesthesia and Analgesia, Vol. 72, No. 1, 1991, p. 94-100.

Research output: Contribution to journalArticle

Kang, Y, Aggarwal, S, Virji, M, Pasculle, AW, Lewis, JH, Freeman, JJ & Martin, LK 1991, 'Clinical evaluation of autotransfusion during liver transplantation', Anesthesia and Analgesia, vol. 72, no. 1, pp. 94-100.
Kang Y, Aggarwal S, Virji M, Pasculle AW, Lewis JH, Freeman JJ et al. Clinical evaluation of autotransfusion during liver transplantation. Anesthesia and Analgesia. 1991;72(1):94-100.
Kang, Y. ; Aggarwal, S. ; Virji, M. ; Pasculle, A. W. ; Lewis, J. H. ; Freeman, Judith (Judy) ; Martin, L. K. / Clinical evaluation of autotransfusion during liver transplantation. In: Anesthesia and Analgesia. 1991 ; Vol. 72, No. 1. pp. 94-100.
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