Minimizing the use of homologous blood products during repair of abdominal aortic aneurysms.

The recent threat of post-transfusion AIDS and increased awareness of blood-related hepatitis have compelled surgeons to minimize the use of homologous blood products during aortic aneurysm repair. Reducing or eliminating homologous blood transfusion can be achieved by aggressive attention to three aspects of patient care: (1) routine use of autologous transfusion; (2) careful surgical technique, emphasizing the minimum dissection needed to expose the aneurysm adequately; and (3) a higher threshold for use of any blood products. In a prospective study of 100 consecutive aortic reconstructions, 80 per cent of patients undergoing aneurysm repair received only their own blood during hospitalization. Routine intraoperative autologous red-cell salvage has also conserved the bank blood supply by reducing usage of homologous blood by 75 per cent. The key to minimizing homologous blood requirements for aneurysm repair has been the development of rapid cell-washing autotransfusion devices.