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GENERAL ARTICLES

Preoperative Autologous Donation Versus Cell Salvage in the Avoidance of Allogeneic Transfusion in Patients Undergoing Radical Retropubic Prostatectomy

Jonathan H. Waters, MD^*, Julia ShinJung Lee, MPH MS, Eric Klein, MD, Jerome O’Hara, MD^*, Craig Zippe, MD, and Paul S. Potter, MD^*

Departments of *General Anesthesiology, Biostatistics, and Urology, Cleveland Clinic Foundation, Cleveland, Ohio

Address correspondence and reprint requests to Jonathan H. Waters, MD, Department of General Anesthesiology, Cleveland Clinic Foundation, 9500 Euclid Ave., E31, Cleveland, OH 44195. Address e-mail to watersj{at}ccf.org

There are many methods for preventing allogeneic blood administration during radical retropubic prostatectomy, and many of these methods have been compared with each other, but no studies have compared preoperative autologous donation (PAD) and cell salvage (CS). In this study, we evaluated these two methods in patients undergoing radical retropubic prostatectomy. In a prospective cohort model, allogeneic exposure in patients from one surgeon who routinely had his patients donate blood before surgery was compared with that in patients from a different surgeon who predominantly used CS. Fifty patients were enrolled in the study: 26 in the PAD group and 24 in the CS group. No difference in allogeneic exposure was seen between the two groups. A significant difference was seen in the volume of red blood cells lost (891 ± 298 mL versus 1134 ± 358 mL in the PAD and CS groups, respectively). We conclude that PAD and CS are equivalent in their ability to avoid allogeneic transfusion. Larger surgical blood loss in the CS group would suggest that in a more rigorously designed study, CS might provide better allogeneic avoidance than PAD.

IMPLICATIONS: In this prospective cohort study, cell salvage and preoperative autologous donation were compared with respect to their ability to avoid allogeneic transfusion. There was a suggestion that cell salvage might offer better allogeneic transfusion avoidance.

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