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Recycling a patient's lost blood during surgery better than using banked blood
Date:5/8/2014

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Such recycling first became popular during the early years of the HIV/AIDS crisis, so patients could avoid the risk of getting the virus in transfused blood. Today, Frank says, the blood supply is much safer, with the incidence of contracting HIV from a transfusion down from one in 100 in the early 1980s to one in 2 million now but focus should be on recycling, because fresher blood is better. The practice also reduces the risk of contracting hepatitis B or C infections, or of bad transfusion-related reactions, Frank adds.

For the study, the Johns Hopkins researchers categorized 32 cardiac surgery patients by their transfusion status: those who received only their own recycled red blood cells (12 patients), those who received their own blood plus fewer than five units of banked blood (10) and those who received their own blood plus five or more units of stored blood (10). All had blood samples drawn before, during and for three days after surgery. The samples were examined for blood cell membrane stiffness and flexibility, a measure of how well oxygen is likely to get to where it is needed.

In patients who received only their own recycled blood, their cells behaved normally right away, as if they had never been outside the body. The more blood a patient got from the bank, the less flexible their entire population of red blood cells. Three days after surgery, the red blood cells in the group that got the largest number of transfused units still had not recovered their full function.

"If something is bad for you, a little bit might be OK, but a lot of it is much worse," Frank says. "It turns out that blood is more like milk, which has a relatively short shelf life, than a fine wine, which gets better with age."

Frank cautions that cell saver machines are not appropriate for all operations, and not all hospitals have access to round-the-clock perfusionists to run them. For heart surgeries, however, a perfusionist is already i
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Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medicine
Source:Eurekalert

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