• M J Dalrymple-Hay, L Pack, C D Deakin, S Shephard, S K Ohri, M P Haw, S A Livesey, and J L Monro.
• Wessex Cardiothoracic Centre, Department of Cardiothoracic Surgery, Southampton General Hospital, UK. mdh@btinternet.com
• Eur J Cardiothorac Surg. 1999 Jun 1; 15 (6): 830-4.

ObjectivesThe National Blood Service issues 2.2 million units of blood per year, 10% of these (220000) are utilized in cardiac procedures. Transfusion reactions, infection risk and cost should stimulate us to decrease this transfusion rate. We test the efficacy of autotransfusion following surgery in a prospective randomized trial.MethodsOne hundred and twelve patients undergoing CABG, valve or CABG + valve procedures were randomized into two groups. Group A received washed postoperative drainage fluid and group C were controls. The indication for transfusion was a postoperative haemoglobin (Hb) < 10 g/l or a PCV < 30. There was no significant difference in preoperative and operative variables between the groups.ResultsTwenty-eight patients in group A and 46 in group C required homologous transfusion (P = 0.0008). Group A patients required 298+/-49 ml of banked blood per patient, group C 508+/-49 ml (P = 0.003). There was no difference in total blood required (volume autotransfused + volume banked blood transfused) between the groups (group A 404+/-50 ml, group C 508+/-50 ml) or in mean total mediastinal fluid drainage (group A 652+/-51 ml, group C 686+/-50ml). The mean Hb concentration was significantly higher in group A on day 1 (11.2 g/dl+/-51 vs. 10.6 g/dl+/-13 (P = 0.002)). No morbidity was associated with autotransfusion.ConclusionAutotransfusion can decrease the amount of homologous blood transfused following cardiac surgery. This represents a benefit to the patient and a decrease in cost to the health service.

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