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Hematologic Integrity After Intraoperative Allotransfusion: Comparison With Bank Blood

Hematologic Integrity After Intraoperative Allotransfusion: Comparison With Bank Blood Abstract Intraoperative allotransfusion is a possible therapeutic alternative to the infusion of large amounts of bank blood. We have compared blood collected intraoperatively by this technique with bank blood given during surgery. High degrees of microaggregation were found in blood from both sources. Marked hemolysis and loss of red cell mass were encountered in allotransfused blood. Bank blood was very acidotic, while a compensated alkalosis of lesser severity was found in allotransfused blood. We present a technique of regional anticoagulation and discuss the rate of surgical blood loss on the chemical and morphologic integrity of blood collected by allotransfusion. References 1. Mosely RV, Doty DB: Changes in filtration characteristics of stored blood . Ann Surg 171:329-335, 1970.Crossref 2. Swank RL: Alteration of blood on storage: Measurement of adhesiveness of "aging" platelets and leukocytes and their removal by filtration . N Engl J Med 265:728-733, 1961.Crossref 3. Sukhandan R, Thal AP: The effects of endotoxin and vasoactive agents on dibenzylene pretreated lungs . Surgery 58:185-193, 1965. 4. Hissen W, Swank RL: Screen filtration pressure and pulmonary hypertension . Am J Physiol 209:715-722, 1965. 5. McNamara JJ, Burran EL, Carson E, et al: Effect of debris in stored blood on pulmonary microvasculature . Ann Thorac Surg 14:133-138, 1972.Crossref 6. Klebanoff G: Early clinical experience with a disposable unit for the intraoperative salvage and reinfusion of blood loss (intraoperative autotransfusion) . Am J Surg 120:718-724, 1970.Crossref 7. Brener BJ, Raines JK, Darling RC: Intraoperative autotransfusion in abdominal aortic resections . Arch Surg 107:78-84, 1973.Crossref 8. Rakower SR, Worth MH: Autotransfusion: Perspective and critical problems . J Trauma 13:573-574, 1973.Crossref 9. Bennett SH, Geelhoed GW, Gralnick HR, et al: Effects of auto transfusion on blood elements . Am J Surg 125:273-278, 1973.Crossref 10. Symbas PN: Autotransfusion from hemothorax: Experimental and clinical studies . J Trauma 12:689-695, 1972.Crossref 11. Swank RL, Roth JG, Jansen J: Screen filtration pressure method and adhesiveness and aggregation of blood cells . J Appl Physiol 19:340-346, 1964. 12. Allison AC, Rees W: The binding of hemoglobin by plasma proteins (haptoglobins) . Br Med J 2:1137-1149, 1957.Crossref 13. Muller-Eberhard U: Hemopexin . N Engl J Med 283:1090-1093, 1970.Crossref 14. Bunn HF, Esham WT, Bull RW: The renal handling of hemoglobin: I. Glomerular filtration . J Exp Med 129:909-924, 1969.Crossref 15. Bunn HF, Jandl JH: The renal handling of hemoglobin: II. Catabolism . J Exp Med 129:925-934, 1969.Crossref 16. Ericcson J: Transport and digestion of hemoglobin in the proximal tubule . Lab Invest 14:1-24, 1965. 17. Ericsson JLE: Absorption and decomposition of homologous hemoglobin in renal proximal tubular cells . Acta Pathol Microbiol Scand , (suppl 168) , pp 1-121, 1964. 18. Andersen MN, Mouritzer CV, Gabrielli ER: Mechanisms of plasma hemoglobin clearance and selective deposit in the liver and kidney: Serum haptoglobin levels and selective deposition in liver and kidney . Ann Surg 164:905-916, 1966.Crossref 19. Rabiner SF, Helbert JR, Lopas H, et al: Evaluation of a stroma-free hemoglobin solution for use as a plasma expander . J Exp Med 126:1127-1142, 1967.Crossref 20. Ostrow JD, Jandl JH, Schmid R: The formation of bilirubin from hemoglobin in vivo . J Clin Invest 41:1628-1641, 1962.Crossref 21. Hardaway RM: Microcoagulation in shock . Am J Surg 110:298-303, 1965.Crossref 22. Vassal P, Simon G, Rouiller C: Electron microscopic study of glomerular lesions resulting from intravascular fibrin formation . Am J Pathol 43:579-588, 1963. 23. Relihan M, Litwin MS: Effects of stroma-free hemoglobin solution on clearance rate and renal function . Surgery 71:395-399, 1972. 24. Relihan M, Olsen RE, Litwin MS: Clearance rate and effect on renal function of stroma-free hemoglobin following renal ischemia . Ann Surg 176:700-704, 1972.Crossref 25. Anderson MN, Kuchiba K: Blood trauma produced by pump oxygenators . J Thorac Cardovasc Surg 57:238-242, 1969. 26. Osborn JJ, Cohn K, Hait M, et al: Hemolysis during perfusion . J Thorac Cardiovasc Surg 43:459-468, 1962. 27. Goldiner PL, Howland WS, Ray C: Filter for prevention of microembolism during massive transfusions . Anesth Analg 51:717-725, 1972. 28. Reul GJ, Greenberg SD, Lefrak EA, et al: Prevention of post-traumatic pulmonary insufficiency: Fine screen filtration of blood . Arch Surg 106:386-394, 1973.Crossref 29. Rocha e Silva M: Klinin Hormones . Springfield, Ill, Charles C Thomas Publisher, 1970, pp 137-204. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Hematologic Integrity After Intraoperative Allotransfusion: Comparison With Bank Blood

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Publisher
American Medical Association
Copyright
Copyright © 1974 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1974.01350300069017
Publisher site
See Article on Publisher Site

Abstract

Abstract Intraoperative allotransfusion is a possible therapeutic alternative to the infusion of large amounts of bank blood. We have compared blood collected intraoperatively by this technique with bank blood given during surgery. High degrees of microaggregation were found in blood from both sources. Marked hemolysis and loss of red cell mass were encountered in allotransfused blood. Bank blood was very acidotic, while a compensated alkalosis of lesser severity was found in allotransfused blood. We present a technique of regional anticoagulation and discuss the rate of surgical blood loss on the chemical and morphologic integrity of blood collected by allotransfusion. References 1. Mosely RV, Doty DB: Changes in filtration characteristics of stored blood . Ann Surg 171:329-335, 1970.Crossref 2. Swank RL: Alteration of blood on storage: Measurement of adhesiveness of "aging" platelets and leukocytes and their removal by filtration . N Engl J Med 265:728-733, 1961.Crossref 3. Sukhandan R, Thal AP: The effects of endotoxin and vasoactive agents on dibenzylene pretreated lungs . Surgery 58:185-193, 1965. 4. Hissen W, Swank RL: Screen filtration pressure and pulmonary hypertension . Am J Physiol 209:715-722, 1965. 5. McNamara JJ, Burran EL, Carson E, et al: Effect of debris in stored blood on pulmonary microvasculature . Ann Thorac Surg 14:133-138, 1972.Crossref 6. Klebanoff G: Early clinical experience with a disposable unit for the intraoperative salvage and reinfusion of blood loss (intraoperative autotransfusion) . Am J Surg 120:718-724, 1970.Crossref 7. Brener BJ, Raines JK, Darling RC: Intraoperative autotransfusion in abdominal aortic resections . Arch Surg 107:78-84, 1973.Crossref 8. Rakower SR, Worth MH: Autotransfusion: Perspective and critical problems . J Trauma 13:573-574, 1973.Crossref 9. Bennett SH, Geelhoed GW, Gralnick HR, et al: Effects of auto transfusion on blood elements . Am J Surg 125:273-278, 1973.Crossref 10. Symbas PN: Autotransfusion from hemothorax: Experimental and clinical studies . J Trauma 12:689-695, 1972.Crossref 11. Swank RL, Roth JG, Jansen J: Screen filtration pressure method and adhesiveness and aggregation of blood cells . J Appl Physiol 19:340-346, 1964. 12. Allison AC, Rees W: The binding of hemoglobin by plasma proteins (haptoglobins) . Br Med J 2:1137-1149, 1957.Crossref 13. Muller-Eberhard U: Hemopexin . N Engl J Med 283:1090-1093, 1970.Crossref 14. Bunn HF, Esham WT, Bull RW: The renal handling of hemoglobin: I. Glomerular filtration . J Exp Med 129:909-924, 1969.Crossref 15. Bunn HF, Jandl JH: The renal handling of hemoglobin: II. Catabolism . J Exp Med 129:925-934, 1969.Crossref 16. Ericcson J: Transport and digestion of hemoglobin in the proximal tubule . Lab Invest 14:1-24, 1965. 17. Ericsson JLE: Absorption and decomposition of homologous hemoglobin in renal proximal tubular cells . Acta Pathol Microbiol Scand , (suppl 168) , pp 1-121, 1964. 18. Andersen MN, Mouritzer CV, Gabrielli ER: Mechanisms of plasma hemoglobin clearance and selective deposit in the liver and kidney: Serum haptoglobin levels and selective deposition in liver and kidney . Ann Surg 164:905-916, 1966.Crossref 19. Rabiner SF, Helbert JR, Lopas H, et al: Evaluation of a stroma-free hemoglobin solution for use as a plasma expander . J Exp Med 126:1127-1142, 1967.Crossref 20. Ostrow JD, Jandl JH, Schmid R: The formation of bilirubin from hemoglobin in vivo . J Clin Invest 41:1628-1641, 1962.Crossref 21. Hardaway RM: Microcoagulation in shock . Am J Surg 110:298-303, 1965.Crossref 22. Vassal P, Simon G, Rouiller C: Electron microscopic study of glomerular lesions resulting from intravascular fibrin formation . Am J Pathol 43:579-588, 1963. 23. Relihan M, Litwin MS: Effects of stroma-free hemoglobin solution on clearance rate and renal function . Surgery 71:395-399, 1972. 24. Relihan M, Olsen RE, Litwin MS: Clearance rate and effect on renal function of stroma-free hemoglobin following renal ischemia . Ann Surg 176:700-704, 1972.Crossref 25. Anderson MN, Kuchiba K: Blood trauma produced by pump oxygenators . J Thorac Cardovasc Surg 57:238-242, 1969. 26. Osborn JJ, Cohn K, Hait M, et al: Hemolysis during perfusion . J Thorac Cardiovasc Surg 43:459-468, 1962. 27. Goldiner PL, Howland WS, Ray C: Filter for prevention of microembolism during massive transfusions . Anesth Analg 51:717-725, 1972. 28. Reul GJ, Greenberg SD, Lefrak EA, et al: Prevention of post-traumatic pulmonary insufficiency: Fine screen filtration of blood . Arch Surg 106:386-394, 1973.Crossref 29. Rocha e Silva M: Klinin Hormones . Springfield, Ill, Charles C Thomas Publisher, 1970, pp 137-204.

Journal

Archives of SurgeryAmerican Medical Association

Published: Jun 1, 1974

References