Cell Salvage Machines for Bloodless Surgery

Cell salvage machines, also known as autotransfusion devices, are medical devices used to collect and process a patient’s own blood during surgery or after significant blood loss. These machines offer several important benefits in healthcare:

1. Minimizing the Need for Donor Blood: One of the primary benefits of cell salvage machines is their ability to reduce the reliance on donor blood transfusions. By collecting and reinfusing a patient’s own blood, these machines help conserve the limited supply of donated blood, which is especially important during blood shortages or in cases where a patient has specific requirements or concerns about receiving donor blood.
2. Reducing the Risk of Transfusion Reactions: When a patient receives their own blood through cell salvage, there is a significantly lower risk of transfusion reactions compared to receiving donor blood. Transfusion reactions, which can be allergic or result from incompatibility, can be serious and sometimes life-threatening. Using a patient’s own blood eliminates these risks.
3. Preserving Blood Components: Cell salvage machines separate the collected blood into its different components (e.g., red blood cells, plasma), allowing healthcare providers to target specific components needed for transfusion. This preservation of blood components is valuable because it ensures that the patient receives the most appropriate and tailored treatment.
4. Maintaining Haemoglobin Levels: By returning the patient’s own blood to their circulation, cell salvage machines help maintain haemoglobin levels and oxygen-carrying capacity. This is especially crucial for patients who have undergone significant blood loss during surgery or trauma.
5. Decreasing the Risk of Infections: Transfusing a patient’s own blood reduces the risk of infection transmission associated with donor blood transfusions. Although donated blood is screened rigorously, there is always a small risk of infection transmission, which is eliminated when using a patient’s own blood.
6. Shortening Recovery Time: Since autotransfusion uses the patient’s own blood, it is typically well-tolerated by the body. This can lead to a quicker recovery after surgery, as there is no need for the immune system to adapt to foreign blood components.
7. Cost-Efficiency: Cell salvage can be cost-effective in the long run, as it reduces the need for purchasing and administering donor blood. It can also decrease the length of hospital stays by helping patients recover more quickly.
8. Easing Ethical and Religious Concerns: Some patients may have ethical or religious objections to receiving donor blood, making autotransfusion a preferred option for them.

In summary, cell salvage machines offer numerous benefits in healthcare by reducing the need for donor blood, minimizing transfusion-related risks, preserving blood components, maintaining haemoglobin levels, reducing the risk of infections, promoting quicker recovery, and accommodating individual patient preferences and beliefs. These machines play a valuable role in improving patient outcomes and optimizing healthcare resource utilization.

Illustrating Cell Salvage Usage:

Example: Emily was involved in a serious car accident, resulting in severe internal injuries that required emergency surgery. Due to the extent of her injuries, the surgical team anticipated significant blood loss during the procedure.

In the operating room, the medical team employed a cell salvage machine to collect and process Emily’s own blood as it was shed during surgery. The machine efficiently separated and cleaned her blood, allowing the team to return the purified blood to her circulation as needed. This process not only reduced the need for donor blood but also ensured that Emily’s body received blood tailored to her unique needs.

As a result of the use of the cell salvage machine, Emily’s surgery went smoothly, and her recovery was faster than expected. She did not experience any transfusion reactions or complications, and her haemoglobin levels remained stable throughout her recovery. This anecdote underscores the vital role that cell salvage machines play in improving patient outcomes and providing tailored, safe, and cost-effective healthcare solutions.

Benefits of Cell Salvage as shown by The British Journal of Anaesthesia

In 2007-2008, UK blood services provided a lot of different blood products to help patients. They gave out 2,174,256 units of red blood cells, 258,419 units of platelets, 295,085 units of frozen plasma, and 117,699 units of cryoprecipitate. However, the total number of these blood products given to patients has been going down in the past 10 years. In 2008, there were 1,049 bad events reported related to transfusions.

Cell salvage is an essential part of saving blood, which means using less blood from donors. This helps lower the chances of problems for patients who get blood from other people. Getting blood from other people can increase the risk of problems like cancer coming back, infections after surgery, heart problems, and even death within five years.

The chances of having infections or cancer return because of blood from other people depend on how much blood someone gets. It seems like the blood might change how our immune system works, which can make these problems more likely. A study on kidney transplant patients found that getting blood from other people could make their bodies less likely to reject the new kidney. But, getting a lot of blood from other people can also make it harder to find a good match for future blood transfusions, which takes more time and can be tricky. (full article, here)

Summarising the Principles of cell salvage for blood recycling

1. Blood Collection:
• Blood is collected from the surgical field, typically from areas where significant bleeding occurs. This blood is typically contaminated with tissue debris, cells, and other materials.

2. Anticoagulation:
• Anticoagulants are added to the collected blood to prevent it from clotting while in the collection reservoir. Commonly used anticoagulants include citrate.

3. Blood Processing:
• The collected blood is processed in a cell salvage machine, which separates the red blood cells (RBCs) from the rest of the components, such as plasma and debris. This separation is achieved through centrifugation or filtration.

4. Washing and Filtering:
• The separated RBCs are then washed and filtered to remove any remaining contaminants, such as free haemoglobin, cell debris, and medications. This process helps ensure that the collected blood is safe for reinfusion.

5. Resuspension:
• Once the RBCs are cleaned and filtered, they are resuspended in a saline solution to create a concentrated and properly balanced blood product suitable for transfusion.

6. Quality Control:
• The processed blood is subject to rigorous quality control measures to ensure that it meets safety and efficacy standards. These measures include haematocrit (RBC concentration) checks and the detection of any contamination.

7. Reinfusion:
• The processed and cleaned blood is then reinfused back into the patient. This can help replenish the patient’s blood volume and minimize the need for donor blood transfusions. It is typically administered through an IV line during or after surgery.

8. Compatibility:
• Since the blood being recycled is from the patient themselves, there are no issues with blood type compatibility or potential transfusion reactions.

9. Infection Control:
• Strict infection control measures are followed to ensure that the collected blood does not become contaminated during the collection, processing, or reinfusion phases.

10. Patient Selection:
• Not all patients require cell salvage. It is typically used in surgeries where significant blood loss is expected, and the blood can be effectively collected and processed.

The use of cell salvage can help reduce the need for allogeneic blood transfusions, which carry certain risks, such as transfusion reactions and the transmission of infectious diseases. It can be particularly beneficial for patients who may have religious or ethical objections to receiving donor blood or those who have specific medical conditions that make them poor candidates for allogeneic transfusions.

The effectiveness of cell salvage depends on the patient’s overall health and the specific surgical procedure being performed.

MedStar Health have a great, short video on – Cell Salvage and Hemodilution, which can be found – <<here>>

These Cell Salvage systems are making huge leaps forward in people not needing bloods. A good article below shows this system used in another “real world” environment.

Clinical Efficacy of Intra-Operative Cell Salvage System in Major Spinal Deformity Surgery

A snippet of the article:

The purpose of this study was to determine the efficacy of intra-operative cell salvage system (ICS) to decrease the need for allogeneic transfusions in patients undergoing major spinal deformity surgeries. Methods: A total of 113 consecutive patients undergoing long level posterior spinal segmental instrumented fusion (≥5 levels) for spinal deformity correction were enrolled.

Full article – <<here>>

Key words, phrases and their meaning from our Medical Protection System

Anaemia is a tricky one when it comes to blood transfusions and iron shots.

My Medical Choice is not here to judge your decision, it is about empowering people to control their own healthcare.

My Medical Choice is all about your Medical Autonomy in healthcare and making sure the emergency team treating you follows your specific wishes. When used correctly, it is a powerful system that can notify medical teams about allergies, procedures etc., right down to more personalised decisions such as people concerned about mRNA in blood, and/or, wanting a solution to vaccinated blood (as listed in the examples in some articles).