Health: Just What the Patient Ordered If You Need a Transfusion during an Operation, Recycling Your Own Blood Will Help You to Recover Faster

Article excerpt

When Claire Rayner had to have an operation to replace her knee joint, she knew that it would involve the loss of a lot of blood, so she thought she would rather have her own than a donation from a stranger. "I wanted to give some of my own blood well in advance and have it back when I needed it," she said.

Ms Rayner was disappointed, however, because the hospital did not operate an autologous blood transfusion scheme. This process, where the patient's own blood is used, is already relieving pressure on donated blood stocks and improving recovery times for patients. However, 20 hospitals around the country are now using an even smarter method, called intra-operative salvage.

"What happens in most hospitals is that, when a patient loses blood during an operation, it is collected and poured away, which is an astonishing waste of a precious resource," says Dr Mike Thomas, a consultant in transfusion medicine and the chairman of the special interest group of the British Blood Transfusion Society. During the intra-operative salvage process, blood is taken away by suction, as in normal operations, and is then fed through a tube to a machine which begins a washing procedure to make it ready for transfusion. The main advantage in patients being given their own blood is that it helps to avoid the efficiency of their immune system being reduced as a result of using somebody else's blood. "The body does not recognise the donated blood cells as its own and does not accept them at first, and this allows bacteria to creep in by default," explains Dr Thomas. "Patients who have autologous transfusions are therefore less likely to develop post-operative infections and, on average, they leave hospital two to five days earlier than those who receive donated (or homologous) blood." At Southmead Hospital in Bristol, a study of orthopaedic patients who had received autologous transfusions showed this to be the case, and the hospital's use of costly blood stocks and antibiotics has also been reduced. Dr Carl Waldmann, the director of intensive care at the Royal Berkshire Hospital Trust, in Reading, says: "The introduction of intra-operative cell salvage has proved very beneficial as we now use less donated blood, which is very expensive - we estimate that donated blood costs around pounds 50 per unit {about a pint}. "Patients are comfortable in the knowledge that they will, in most cases, be given their own blood," he explains. "There is a genuine underlying concern among patients about the potential risk of exposure to HIV." One patient who has felt the benefit of recycling his own blood is Stanley Yentis, aged 72, who lives in Heron Island, Berkshire. He was diagnosed as having an aortic aneurism, a potentially life- threatening condition, and went into hospital for a three-hour operation. During the operation he was given an autologous transfusion of around 12 units of his own blood. "The doctor told me I would be given my own blood, but it didn't really mean much to me," says Mr Yentis. "I certainly had no problems with the system, and I felt fine four days later." Mr Yentis developed no post-operative infection, the risk of which is higher in older patients, and was allowed home four days after surgery, whereas most patients recovering from similar operations have to stay in hospital for around 10 days. …