Obstetric intra-operative cell salvage: a review of an established cell salvage service with 1170 re-infused cases.

This is a retrospective report of 10 years of obstetrical cell salvage use in a single hospital. The authors report on 1170 patients who had a median of 231 mL of blood reinfused. This article contributes to the growing amount of information on the safety of cell salvage use in obstetrics.

Over the 10 years of their study, they observed a reduction in allogeneic blood use from 1.4% in 2008 to 0.4% in 2017. During the same period, they saw a steady increase in the amount of autologous blood re-infused. It is difficult to directly correlate the increasing use of cell salvage with the decreases in use of allogeneic blood because they also implemented an intravenous iron programme and started using tranexamic acid during the same study period. What can be concluded is that the three strategies together resulted in a significant reduction in allogeneic blood exposure.

In this patient population of young women, the long-term consequences of allogeneic transfusion are poorly understood. The best way of eliminating this unknown risk is through a comprehensive patient blood management programme as is illustrated by this article.

– Jonathan H. Waters