P06 Use of Intraoperative Red Cell Salvage During Elective Abdominal Aortic Aneurysm Repair is Safe and Associated with Reduced Need for Allogeneic Blood Transfusion.

Introduction  The need for blood transfusion during vascular surgery can be considerable. Concerns regarding the safety and cost of allogeneic blood have demanded scrutiny of alternative methods of blood conservation during these operations, including intraoperative red cell salvage. Autotranfusion is purported to reduce the need for blood transfusion, and therefore its attendant complications. Method  We retrospectively collected data on all patients undergoing elective infrarenal abdominal aortic aneurysm repair in our unit, and compared patients in which the cell saver was used to those in which it was not, in terms of operative blood loss, transfusion requirement, length of stay, and postoperative haemoglobin. The Mann Whitney test and Kendall's tau B statistics were used to analyse the data Results  Thirty-five patients underwent AAA repair with use of the cell saver, and 31 patients underwent repair without the use of this device. We found a significant association between the use of the cell saver and reduced need for allogneic blood in these patients (Table). There was also a significant positive correlation between the volume of blood obtained by the cell saver, and that returned to the patient (t = +0.5, P < 0.00001). The postoperative haemoglobin in the cell saver group was significantly lower, but still within acceptable range. There was no significant difference in mortality between the two groups; Variable Cell Saver Group -Mean No-Cell Saver Group - Mean Significance Age (years) 72.4 (8.1) 74.5 (7.1) 0.11 AAA size (cm) 6.2 (0.9) 6.1 (0.7) 0.94 Preop Hb (g/dL) 13.9 (1.2) 13.9 (1.6) 0.92 Operative blood loss (mL) 986.7 (494.2) 1900.6 (1657.6) 0.02 Intraoperative allogeneic blood used (no. units) 0.5 (1.2) 2.6 (2.8) <0.0001 Total allogeneic blood (7d) 0.9 (1.4) 3.5 (4.3) <0.0001 Post operative Hb 10.9 (1.2) 11.7 (1.7) 0.03 Length of stay (days) 12.5 (4.2) 10.7 (8.1) 0.01 Conclusion  Our study indicates that use of the cell saver in elective AAA repair is associated with a reduced need for allogeneic blood transfusion, and therefore, with a reduction in risks of transmitted infection and transfusion reaction. These findings also have important financial implications.