INTRA-OPERATIVE AUTOLOGOUS BLOOD RECOVERY:CELL SAVING

History

During major spine surgery a patient will always have a certain amount of blood loss. To compensate for this, matched donor blood – blood donated by people who are strangers to the patient, at the blood bank - would be given to the patient. Unfortunately in the society we live in today, donor blood has become less accessible and virus free blood cannot be totally guaranteed.

To compensate for this, a system known as cell saving has been developed to fill the gap, whereby the patient’s own blood is transfused (given via an intravenous ‘drip’) back to him/her during or after surgery.

How does it work?

1. The principle involved is simple: Blood is thicker than water.

2. During surgery the patient’s blood is collected in a collection reservoir. The blood is filtered so as to prevent any debris contaminating the blood. Figure 1.

3. An anti-coagulant is added to the collected blood to prevent it from clotting.

4. The collected blood is then processed by means of a centrifuge. Figure 2. (During this phase the red cells are separated from the rest of the material collected from the patient).

5. After the separation the red cells are then washed Figure 3. Dead red cells - cells that can no longer carry oxygen, are washed out, as well as the anti-coagulant given previously.

6. When the wash cycle has been completed, the compacted red cells are returned into a collection bag for re-infusion into the patient. Figure 4.

Figure 1  Figure 2
Figure 3 Figure 4

Jehovah’s Witnesses?

 This is an approved method of returning blood to a patient who is a Jehovah’s Witness. The only difference being is that the whole setup is done prior to surgery and the patient is connected directly to the collection bag, thus ensuring that the blood cycle is never broken.

Cancer?

 Care must always be taken as with any procedure, but it is safe to return the patient’s blood as long as the wash protocol for the cancer patient is followed.

 Is the blood safe and infection free?

 Yes, because the blood is processed in the operating theatre in a closed system, there is no chance for the blood to be contaminated from the outside. The only contamination may come from the patients themselves, but this is very rare, so the blood is safe.

 Who performs the service?

 A qualified Perfusionist registered with the Medical Council operates the cell saver. They have had special training in the management of blood and the operation of the Cellsaver machine itself.

 How do I arrange for cell saving?

Ask your surgeon, he/she will have all the information necessary

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