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. 2023 Sep 8;2023(9):CD001888. doi: 10.1002/14651858.CD001888.pub5

6. Overview of included studies (PICO) ‐ Cardiovascular (with bypass).

Study details Population (surgery type) CS detail Intervention detail Control detail Outcomes reported (time point)
Adan 1988
RCT 
Registration: N/A 
Country: The Netherlands 
N = 50 Cardiothoracic (CABG) (on CPB) Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: Hb < 5 mmol/L 
System: Sorenson system (Sorensen Research Co, Salt Lake City, Utah, USA) Autotransfusion (ATS group)
N = 25 control
N = 25

  • Volume (NA)

  • Blood loss (NA)

  • Mortality ("operative mortality")
Axford 1994
RCT 
Registration: N/A 
Country: USA 
N = 32 Cardiothoracic (CABG, valve) (on CPB) Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: Hct < 25% 
System: Pleur‐evac Autotransfusion System (model A‐5005‐ATS; Deknatel) Group 1: retransfused
N = 16 Group 2: banked blood only
N = 16

  • Transfusions (24 hours)

  • Volume (NR)

  • Blood loss (NR)

  • MI (NR)
Dalrymple‐Hay 1999
RCT 
Registration: N/A 
Country: UK 
N = 112 Cardiothoracic (CABG, valve) (on CPB) Timing of collection: postoperative 
Washing: washed 
Transfusion threshold: Hb < 10 g/dL 
System: Fresenius C.A.T.S. continuous autotransfusion system Group A: autotransfusion drain
N = 56 Group C: control
N = 56

  • Transfusions (24 hours)

  • Volume (24 hours)

  • Blood loss (24 hours)

  • Mortality (NR)

  • Re‐operation (NR)

  • Hospital LOS
Eng 1990
RCT 
Registration: N/A 
Country: UK 
N = 40 Cardiothoracic (CABG) (on CPB) Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: Hct < 25%, Hb < 9 g/dL, Blood loss > 500ml in first 4h 
System: Shiley hardshell venous reservoir Study: autotransfusion
N = 20 Control: usual care (no AT)
N = 20

  • Transfusions (postoperative only)

  • Volume (postoperative only)

  • Mortality (NR)

  • Re‐operation (NR)

  • Wound complication (NR)

  • Hospital LOS
Gäbel 2013a
RCT 
Registration: No trial registration 
Country: Sweden 
N = 30 Cardiothoracic (on CPB) Timing of collection: intraoperative 
Washing: unwashed 
Transfusion threshold: Hb < 80 g/L 
System: cardiotomy suction blood was collected in a separate closed uncoated cardiotomy reservoir (EL402, Medtronic, Minneapolis, USA). Retransfusion
N = 15 No‐retransfusion
N = 15

  • Transfusions (NR)

  • Volume (NR)

  • Blood loss (NA)

  • Re‐operation (postoperative)

  • Infection (NR)

  • VTE/thrombosis (NR)

  • DVT (NR)

  • PE (NR)

  • MACE (NR)

  • MI (NR)

  • CVA/stroke (NR)

  • Hospital LOS (NA)
Klein 2008
RCT 
Registration: N/A 
Country: UK 
N = 213 Cardiothoracic (CABG, valve) (on CPB) Timing of collection: both intra‐ and postoperatively
Washing: washed 
Transfusion threshold: Hb < 8 g/dL 
System: CATS ‐ Fresenius Hemocare, France Cell salvage
N = 102 Control
N = 111

  • Transfusions (intraoperative and postoperative)

  • Volume (NA)

  • Blood loss (NA)

  • Mortality (postoperative)

  • Re‐operation (NR)

  • Wound complication (NR)

  • Hospital LOS (NA)
Koopman‐van Gemert 1993a
RCT 
Registration: N/A 
Country: The Netherlands 
N = 40 Cardiothoracic (CABG) (on CPB) Timing of collection: both intra‐ and postoperatively
Washing: washed 
Transfusion threshold: Hct < 30% 
System: Cell saver III‐plus (Haemonetics Corporation, Braintree, USA) Group 1: perioperative autotransfusion
N = 20 Group 2: homologous transfusion only
N = 20

  • Transfusions (intraoperative and postoperative)

  • Volume (intraoperative and postoperative)

  • Blood loss (perioperative)
Lepore 1989
RCT 
Registration: N/A 
Country: Sweden 
N = 135 Cardiothoracic (on CPB) Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: No protocol 
System: Dideco 742. Nordmedic. Sweden and Sorensen Receptaseal, Abbot Scand. Sweden Autotransfusion
N = 67 Control
N = 68

  • Transfusions (postoperative)

  • Volume (postoperative)

  • Blood loss (6 hours )

  • Mortality (5 days)
Marberg 2010
RCT 
Registration: No trial registration 
Country: Sweden 
N = 80 Cardiothoracic (CABG) (on CPB) Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: Hb < 80 g/L 
System: NR Autotransfusion
N = 40 No Autotransfusion
N = 40

  • Transfusions (in‐hospital)

  • Volume (NA)

  • Blood loss (postoperative 12 hours)

  • Mortality (perioperative)
Martin 2000
RCT 
Registration: N/A 
Country: USA 
N = 198 Cardiothoracic (CABG, valve) (on CPB) Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: Hb < 80 g/L 
System: Atrium Medical Corporation, Hudson, NH Reinfusion group
N = 98 Control group
N = 100

  • Transfusions (NR)

  • Volume (NR)

  • Blood loss (perioperative)

  • Mortality (in‐hospital)

  • Re‐operation (NR)

  • MI (NR)

  • CVA/stroke (NR)
McShane 1987
RCT 
Registration: N/A 
Country: Ireland 
N = 41 Cardiothoracic (on CPB) Timing of collection: intraoperative 
Washing: washed 
Transfusion threshold: No protocol 
System: Dideco Autotrans BT 795 (Dideco S.p.A., Mirandola, Italy) Saved blood group (autotransfusion)
N = 20 Donor blood group (homologous blood only)
N = 21

  • Mortality (immediate postoperative period)
Niranjan 2006 ‐ SUBGROUP on‐CPB
RCT 
Registration: N/A 
Country: UK 
N = 40 Cardiovascular (CABG) (on CPB) Timing of collection: intraoperative 
Washing: washed 
Transfusion threshold: Hb < 8 g/dL 
System: Dideco Electa autotransfuser device (Dideco, Gloucester, United Kingdom) Group A (On‐CPB with CSBT)
N = 20 Group B (On‐CPB without CSBT)
N = 20

  • Volume (24 hours)

  • Blood loss (24 hours)

  • Mortality (in‐hospital)

  • CVA/stroke (in‐hospital)

  • Hospital LOS
Page 1989
RCT 
Registration: N/A 
Country: UK 
N = 99 Cardiothoracic (CABG) (on CPB) Timing of collection: intraoperative 
Washing: unwashed 
Transfusion threshold: Hct < 30% 
System: Bentley Catr hard‐shell cardiotomy reservoir (Bentley‐Edwards CVS Division, Baxter) Healthcare, Newbury, England) Group 2: reinfusion of shed mediastinal blood
N = 48 Group 1: conventional mediastinal drainage
N = 51

  • Transfusions (NR)

  • Volume (NR)

  • Blood loss (18 hours)

  • Re‐operation (in‐hospital)

  • Infection (in‐hospital)
Parrot 1991 ‐ ALL
RCT 
Registration: N/A 
Country: France 
N = 66 Cardiothoracic (CABG) (on CPB) Timing of collection: ALL 
Washing: both 
Transfusion threshold: Hb < 10 g/dL or Hct < 30% 
System: intraoperative: Haemonetics Cell Saver III (Haemonetics Corp. Braintree. MA), postoperative: PLEUR‐EVAC A 4005, Deknatel, Pfizer Hospital Products, Queens Village. NY) and Haemonetics Haemolite. Group 2 and 3
N = 44 Group 1: control
N = 22

  • Transfusions (intraoperative and postoperative)

  • Volume (intraoperative and postoperative)

  • Blood loss (intraoperative and postoperative)

  • Mortality (NR)

  • Infection (NR)
Parrot 1991 ‐ SUBGROUP intraoperative only
RCT 
Registration: N/A 
Country: France 
N = 33 Cardiothoracic (CABG) (on CPB) Timing of collection: intraoperative 
Washing: unwashed 
Transfusion threshold: Hb < 10 g/dL or Hct < 30% 
System: intraoperative: Haemonetics Cell Saver III (Haemonetics Corp. Braintree. MA) Group 2: intraoperative only
N = 22 Group 1: control
N = 11

  • Transfusions (intraoperative and postoperative)

  • Volume (intraoperative and postoperative)

  • Blood loss (intraoperative and postoperative)

  • Mortality (NR)

  • Infection (NR)
Parrot 1991 ‐ SUBGROUP both intra‐ and postoperatively
RCT 
Registration: N/A 
Country: France 
N = 33 Cardiothoracic (CABG) (on CPB) Timing of collection: both intra‐ and postoperatively
Washing: both 
Transfusion threshold: Hb < 10 g/dL or Hct < 30% 
System: intraoperative: Haemonetics Cell Saver III (Haemonetics Corp. Braintree. MA), postoperative: PLEUR‐EVAC A 4005, Deknatel, Pfizer Hospital Products, Queens Village. NY) and Haemonetics Haemolite. Group 3: intraoperative and postoperative
N = 22 Group 1: control
N = 11

  • Transfusions (intraoperative and postoperative)

  • Volume (intraoperative and postoperative)

  • Blood loss (intraoperative and postoperative)

  • Mortality (NR)

  • Infection (NR)
Pleym 2005
RCT 
Registration: N/A 
Country: Norway 
N = 47 Cardiothoracic (CABG) (on CPB) Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: No protocol 
System: Cardiotomy resevoir: Card. Reservoir, filtered; Sorin Biomedica UK, Ltd. Harrogate, UK) Autotransfusion
N = 23 No autotransfusion
N = 24

  • Transfusions (in‐hospital)

  • Blood loss (16 hours (postoperative only))

  • Mortality (in‐hospital)

  • Re‐operation (in‐hospital)
Reyes 2011
RCT 
Registration: No trial registration 
Country: Spain 
N = 63 Cardiothoracic (on CPB) Timing of collection: intraoperative 
Washing: washed 
Transfusion threshold: No threshold 
System: CATS Fresenius Hemocare, France Cell salvage (CS) Group
N = 34 Control group
N = 29

  • Transfusions (30 days)

  • Blood loss (24 hours)

  • Mortality (30 days)

  • Re‐operation (30 days)

  • Infection (30 days)

  • Hospital LOS
Schaff 1978
RCT 
Registration: N/A 
Country: USA 
N = 114 Cardiothoracic (on CPB) Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: Hct < 35% 
System: Sorenson ATS (autotransfusion system) Autotransfusion system (ATS)
N = 63 Control
N = 51

  • Volume (NR)

  • Blood loss (NR)

  • Mortality (NR)

  • Infection (NR)

  • Wound complication (NR)
Schmidt 1996
RCT 
Registration: N/A 
Country: Denmark 
N = 109 Cardiothoracic (CABG) (on CPB) Timing of collection: postoperative 
Washing: NR 
Transfusion threshold: Hb < 5.5 mmol/L 
System: NR Autotransfusion group
N = 53 Control group
N = 56

  • Transfusions (NR)

  • Volume (NA)

  • Blood loss (NA)

  • Infection (NR)

  • MI (NR)
Schönberger 1993
RCT 
Registration: N/A 
Country: The Netherlands 
N = 40 Cardiovascular (CABG) (on CPB) Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: Hct < 25% 
System: NR Group 1: AT (autotransfusion)
N = 20 Group 2: control (homologous blood only)
N = 20

  • Transfusions (24 hours)

  • Volume (24 hours)

  • Blood loss (perioperative)

  • Mortality (perioperative)

  • Re‐operation (in‐hospital)

  • MI (in‐hospital)
Scrascia 2012
RCT 
Registration: No trial registration 
Country: Italy 
N = 34 Cardiothoracic (CABG) (on CPB) Timing of collection: intraoperative 
Washing: washed 
Transfusion threshold: No protocol 
System: Hemonetics® Cell Saver® 5 (Hemonetics Corporation, Braintree, MA USA) Cell Salvage Group
N = 17 Control Group
N = 17

  • Transfusions (24 hours)

  • Volume (NA)

  • Blood loss (48 hours)

  • Mortality (in‐hospital)

  • Re‐operation (NR)

  • CVA/stroke (NR)

  • Hospital LOS
Shen 2016
RCT 
Registration: Prospective 
Country: China 
N = 103 Cardiothoracic (on CPB) Timing of collection: intraoperative 
Washing: washed 
Transfusion threshold: Hb < 8 g/dL 
System: Haemonetics 5+, USA Group CS (cell salvage)
N = 53 Group C (control)
N = 50

  • Transfusions (NR)

  • Volume (NR)

  • Blood loss (NR)

  • Mortality (24 hours)

  • Re‐operation (NR)

  • Wound complication (NR)

  • MI (NR)

  • Hospital LOS
Shirvani 1991
RCT 
Registration: N/A 
Country: UK 
N = 42 Cardiothoracic (CABG) Timing of collection: postoperative 
Washing: NR 
Transfusion threshold: Hct < 30% 
System: Cell Saver device not described. (Device used for reinfusion: IMED 960 Volumetric Infusion) Pump Group 2: autotransfusion
N = 21 Group 1: control
N = 21

  • Transfusions (NR)

  • Volume (NR)

  • Re‐operation (7 days)
Thurer 1979
RCT 
Registration: N/A 
Country: USA 
N = 113 Cardiothoracic (on CPB) Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: No threshold, Hct < 30% + unstable 
System: Sorenson Research Corporation, Salt Lake City, UT Autotransfused Group
N = 54 Control Group
N = 59

  • Transfusions (in‐hospital)

  • Volume (NA)

  • Blood loss (NA)

  • Mortality (in‐hospital)

  • Re‐operation (NR)

  • Infection (NA)

  • Wound complication (NR)

  • MI (NR)
Unsworth 1996
RCT 
Registration: N/A 
Country: UK 
N = 105 Cardiothoracic (CABG) (on CPB) Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: Hct < 25% 
System: NR (Cardiotomy reservoir = CATR 3500) Group 2: uncoated autotransfusion and Group 3: coated autotransfusion (combined)
N = 71 Group 1: no autotransfusion
N = 34

  • Transfusions (NR)

  • Volume (NR)

  • Blood loss (NA)

  • Mortality (NR)

  • Re‐operation (NR)
Vermeijden 2015
RCT 
Registration: Retrospective (one year) 
Country: The Netherlands 
N = 716 Cardiothoracic (CABG, valve) (on CPB) Timing of collection: intraoperative 
Washing: washed 
Transfusion threshold: Hb < 5 mmol/L 
System: The centers used their own CS with standard washing program (CATS [Fresenius], Brat 5 [Haemonetics, Braintree, MA], or Dideco‐electa [Sorin, Milan, Italy] Group CS & Group CS + Filter
N = 364 Group Filter & Group Control
N = 352

  • Transfusions (in‐hospital)

  • Volume (in‐hospital)

  • Blood loss (perioperative)

  • Mortality (1 year)

  • Infection (discharge)

  • MI (NR)

  • CVA/stroke (NR)

  • Hospital LOS
Ward 1993
RCT 
Registration: N/A 
Country: USA 
N = 35 Cardiothoracic (CABG, valve) Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: Hb < 8 g/dL 
System: In‐line autotransfusion system (Gish Biomedical, Inc, Santa Ana, CA) Autotransfusion
N = 18 Control (no autotransfusion)
N = 17

  • Transfusions (NR)

  • Volume (NA)

  • Blood loss (NR)

  • Mortality (NR)

  • Re‐operation (NR)

  • Infection (NR)

  • Wound complication (NR)

  • MI (NR)
Westerberg 2004
RCT 
Registration: N/A 
Country: Sweden 
N = 29 Cardiothoracic (CABG) (on CPB) Timing of collection: both intra and postoperatively
Washing: NR 
Transfusion threshold: No protocol 
System: D 903 Avant, Dideco; Mirandola, Modena, Italy) Retransfusion Group
N = 12 No‐Retransfusion Group
N = 17

  • Transfusions (NR)

  • Blood loss (12 hours )
Xie 2015
RCT 
Registration: Prospective 
Country: China 
N = 150 Cardiothoracic (on CPB) Timing of collection: intraoperative 
Washing: washed 
Transfusion threshold: Hb < 80 g/L 
System: Haemonetics, USA, volume of disposable centrifuge bowl is 125mL Group CS (cell salvage)
N = 75 Group C (control)
N = 75

  • Transfusions (24 hours)

  • Volume (NR)

  • Blood loss (intraoperative)

  • Mortality (24 hours)

  • Hospital LOS
Zhao 2003
RCT 
Registration: N/A 
Country: China 
N = 60 Cardiothoracic (CABG) (on CPB) Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: No protocol 
System: autotransfusion system (Beijing PerMed Biomedical Engineering Co., China) Group 1: shed mediastinal blood
N = 30 Group 2: banked blood only
N = 30

  • Transfusions (NR)

  • Volume (NR)

  • Blood loss (NA)

ANH: acute normovolemic haemodilution; AT: autotransfusion; CABG: cardiopulmonary bypass graft; CS: cell salvage; CVA: cerebrovascular accident; DVT: deep vein thrombosis; Hb: haemoglobin; Hct: haematocrit; LOS: hospital length of stay; MACE: major adverse cardiovascular events; MI: myocardial infarction; N: planned recruitment (as reported by the study); NA: not analysable; NR: not reported; PE: pulmonary embolism; PJI: prosthetic joint infection; RAP: retrograde autologous prime; RCT: randomised controlled trial; VTE: venous thromboembolism

"Registration: N/A" means 'not applicable' as the study was published before 2010
"Volume" refers to mean transfusion volume
"Transfusions" refers to number of people receiving an allogeneic transfusion