Table I.
Clinical studies on cell salvage in obstetrics.
| Year/Author/Publication type | Number of cell-saving procedures (826) | Number of subjects transfused (446) | Re-transfusion rate of salvaged blood (%) | Clinical setting |
|---|---|---|---|---|
| 1983/Keeling115/RS | 43# | Not stated | Not stated | HY, CS, AP |
| 1988/Grimes110/CR | 2 | 2 | 100 | AP/PPH |
| 1990/Zichella116/CR | 8 | 8 | 100 | CS |
| 1993/Jackson117/RS | 119 | 64 | 53 | CS |
| 1996/O’Brien111/RS | 5 | 5 | 100 | Placenta percreta |
| 1998/Rees119/CR | 1 | 1 | 100 | CS/PPH/JW |
| 1998/Rainaldi120/Prospective controlled trial | 34 | 34 | 100 | CS |
| 1998/Rebarber114/Retrospective cohort | 186 | 139 | 74 | CS |
| 1999/Potter113/CR | 1 | 1 | 100 | CS/placenta previa |
| 2000/Oei121/CR | 1 | 1 | 100 | CS/JW/preeclampsia/HELLP |
| 2002/Catling122/CR | 4 | 4 | 100 | Extrauterine placenta/CS PPH CS/JW CS/JW |
| 2003/Waters123/CR | 1 | 1 | 100 | CS/placenta accreta/β-thalassemia intermedia |
| 2003/de Souza124/CR | 1 | 1 | 100 | Placenta praevia/CS/JW |
| 2004/McGurgan125/CR | 1 | 1 | 100 | Placenta praevia/CS/JW |
| 2005/Boonstra46/CR | 1 | 1 | 100 | CS |
| 2007/Teig126/RS* | 182 | 119 | 65 | Not stated |
| 2008/Harkness127/RS** | 7 | 0 | 0 | CS |
| 2008/Nagy76/CR*** | 1 | 1 | 100 | Placenta percreta/JW |
| 2009/Araki128/CR | 1 | 1 | 100 | Placenta accreta |
| 2009/Okunuga129/CR | 2 | 2 | 100 | Placenta praevia/JW/SCT Placenta accreta/SCT |
| 2009/King130/RS | 46 | 19 | 41 | Placenta praevia, suspected placental abruption, multiple pregnancy, multiple repeat CS, previous PPH, refusal of blood transfusion, CS at full dilatation, low preoperative Hb, at the discretion of the theatre team |
| 2009/Eller112/Retrospective cohort | 1 | Not stated | Not stated | Placenta accreta |
| 2010/Parry131/RS | 47 | 17 | 36 | Patients at high risk of haemorrhage (placenta praevia, suspected placental abruption, multiple pregnancy, multiple repeat CS, previous PPH, refusal of blood transfusion, CS at full dilatation, low preoperative Hb, at the discretion of the theatre team, failed induction of labour, failed instrumental delivery) |
| 2010/McDonnell132/Prospective cohort | 51 | 21 | 41 | Placenta praevia, CS, ectopic pregnancy, JW |
| 2010/Sreelakshmi133/CR | 1 | 1 | 100 | CS |
| 2010/Kessack134/CR | 1 | 1 | 100 | CS |
| Year/Author/Publication type | Adverse events | Use of a leucocyte depletion filter | Amount (mL/unit) of autologous blood transfused (T) or yielded (Y) | Units of allogeneic red cells transfused |
|---|---|---|---|---|
| 2010/Hatfield140/CR**** | 1 | 1 | 100 | Placenta accreta |
| 2010/Malik135/RS | 77 | Not stated | Not stated | Placenta praevia, JW |
| 1983/Keeling115/RS | No | No | 700 mL (mean/Y) | Not stated |
| 1988/Grimes110/CR | No | No | AP: 1,700 mL (T) PPH: 2,200 mL (T) |
None |
| 1990/Zichella116/CR | No | No | Not stated | Not stated |
| 1993/Jackson117/RS | No | No | 2 units (mean/T) | Not stated |
| 1996/O’Brien111/RS | Not stated | No | Not stated | Not stated |
| 1998/Rees119/CR | DIC (?) | No | 1,400 mL (T) | None |
| 1998/Rainaldi120/Prospective controlled trial | No | No | 225 mL ±18 (mean/T) | Not stated§ |
| 1998/Rebarber114/Retrospective cohort | Heparin toxicity (n = 1) | No | 250 mL (range: 125–4,750) 543 mL (range: 225–1,160) 450 mL (range: 200–11,250) (median/T) |
Not stated |
| 1999/Potter113/CR | Endomyometritis | No | 250 mL (T) | None |
| 2000/Oei121/CR | Cardiac arrest/death | No | 200 mL (T) | None |
| 2002/Catling122/CR | ARDS/pneumonia | Yes | 1,400 mL (T) | 22 |
| Chest infection | 270 mL (T) | 10 | ||
| Anaemia (n=1) | 350 mL (T) | None | ||
| 245 mL (T) | None | |||
| 2003/Waters123/CR | Anaemia | Yes | 2,250 mL (T) | None |
| 2003/de Souza124/CR | No | No | 350 mL (T) | None |
| 2004/McGurgan125/CR | No | Yes | 400 mL (T) | None |
| 2005/Boonstra46/CR | No | No | 330 mL (T) | None |
| 2007/Teig126/RS* | Not stated | Not stated | Not stated | Not stated |
| 2008/Harkness127/RS** | No | Not stated | 0 | None |
| 2008/Nagy76/CR*** | No | No | 1,769 mL (T) +1,200 mL of whole blood*** |
None |
| 2009/Araki128/CR | No | No | 12,600 mL (T) | 60 |
| 2009/Okunuga129/CR | No | No | 126 mL (T) 1,600 mL (T) |
0 6 |
| 2009/King130/RS | No | Yes | 300 mL (range: 200–800) (median/T) | 2 in 4 patients 24 in 1 patient |
| 2009/Eller112 Retrospective cohort | Not stated | Not stated | Not stated | Not stated |
| 2010/Parry131/RS | No | Not stated | 229 mL (range: 125–534) (mean/T) | Not stated |
| 2010/McDonnell132/Prospective cohort | Hypotension | Yes | 359 mL (range: 60–1,300) (median/T) | 3 (mean) (range: 2–14) |
| 2010/Sreelakshmi133/CR | Hypotension | Yes | 1,000 mL (Y) | 10 |
| 2010/Kessack134/CR | Hypotension | Yes | 600 mL (T) | 9 |
| 2010/Hatfield140/CR**** | Post-bypass bleeding | No | 2,500 mL**** (T) | 5 |
| 2010/Malik135/RS | No | Yes | 95.5 mL (range: 0–1,800) (mean/Y) 13 units (total number/T) |
31 (total number) |
Legend:
#:
includes a not stated number of exploratory laparatomies;
§:
the use of allogeneic blood transfusion was significantly lower in patients submitted to cell salvage;
*:
survey of cell-salvage use (includes 63 episodes of cell-salvage set-up without processing blood);
**:
survey of cell-salvage use;
***:
combined use of acute normovolaemic haemodilution and cell-salvage;
****:
use of standard cardiopulmonary bypass machine and transfusion of unwashed whole blood;
ARDS: adult respiratory distress syndrome; AP: abdominal pregnancy; CR: case report; CS: caesarean section; DIC: disseminated intravascular coagulation; HY: hysterectomy; JW: Jehovah’s witness; PPH: post-partum haemorrhage; RS: retrospective series; SCT: sickle-cell trait.