Relative cost of autologous red cell salvage versus allogeneic red cell transfusion during abdominal aortic aneurysm repair.

The costs of washed autologous red cell concentrate obtained by intraoperative red cell salvage were compared to the costs of allogeneic packed red cell transfusion during 110 consecutive abdominal aortic aneurysm repairs. The mean volume of scavenged blood during elective procedures was 1350 ml (range 350 to 6675 ml, n = 90) and emergency procedures 2750 ml (range 750 to 9400 ml, n = 20). The mean volume of processed (washed) blood returned during elective repairs was 759 ml (range 150 to 2900 ml, n = 51) and emergency repairs 1117 ml (range 0 to 4100 ml, n = 20). During elective repairs, the cost of routine autologous red cell salvage ($151 per 285 ml unit) was only slightly greater than the estimated cost of cross-matched, leucocyte-reduced, allogeneic blood ($143 per 285 ml unit). During emergency repairs, washed autologous red cells ($83 per 285 ml unit) were less expensive than allogeneic packed red cells. These findings indicate that, compared with the use of allogeneic packed red cells, red cell salvage during emergency abdominal aortic aneurysm repair can be justified on an economic basis alone, and that routine red cell salvage during elective repair can achieve the benefits of autologous blood at little extra cost to the community.