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. 2023 Sep 8;9(9):CD001888.
doi: 10.1002/14651858.CD001888.pub5.

Cell salvage for minimising perioperative allogeneic blood transfusion in adults undergoing elective surgery

Thomas D Lloyd #  1 , Louise J Geneen #  2   3 , Keeley Bernhardt  4 , William McClune  4 , Scott J Fernquest  1 , Tamara Brown  5 , Carolyn Dorée  2   3 , Susan J Brunskill  2   3 , Michael F Murphy  6   7 , Antony Jr Palmer  1   7
Affiliations

Cell salvage for minimising perioperative allogeneic blood transfusion in adults undergoing elective surgery

Thomas D Lloyd et al. Cochrane Database Syst Rev. .

Abstract

Background: Concerns regarding the safety and availability of transfused donor blood have prompted research into a range of techniques to minimise allogeneic transfusion requirements. Cell salvage (CS) describes the recovery of blood from the surgical field, either during or after surgery, for reinfusion back to the patient.

Objectives: To examine the effectiveness of CS in minimising perioperative allogeneic red blood cell transfusion and on other clinical outcomes in adults undergoing elective or non-urgent surgery.

Search methods: We searched CENTRAL, MEDLINE, Embase, three other databases and two clinical trials registers for randomised controlled trials (RCTs) and systematic reviews from 2009 (date of previous search) to 19 January 2023, without restrictions on language or publication status.

Selection criteria: We included RCTs assessing the use of CS compared to no CS in adults (participants aged 18 or over, or using the study's definition of adult) undergoing elective (non-urgent) surgery only.

Data collection and analysis: We used standard methodological procedures expected by Cochrane.

Main results: We included 106 RCTs, incorporating data from 14,528 participants, reported in studies conducted in 24 countries. Results were published between 1978 and 2021. We analysed all data according to a single comparison: CS versus no CS. We separated analyses by type of surgery. The certainty of the evidence varied from very low certainty to high certainty. Reasons for downgrading the certainty included imprecision (small sample sizes below the optimal information size required to detect a difference, and wide confidence intervals), inconsistency (high statistical heterogeneity), and risk of bias (high risk from domains including sequence generation, blinding, and baseline imbalances). Aggregate analysis (all surgeries combined: primary outcome only) Very low-certainty evidence means we are uncertain if there is a reduction in the risk of allogeneic transfusion with CS (risk ratio (RR) 0.65, 95% confidence interval (CI) 0.59 to 0.72; 82 RCTs, 12,520 participants). Cancer: 2 RCTs (79 participants) Very low-certainty evidence means we are uncertain whether there is a difference for mortality, blood loss, infection, or deep vein thrombosis (DVT). There were no analysable data reported for the remaining outcomes. Cardiovascular (vascular): 6 RCTs (384 participants) Very low- to low-certainty evidence means we are uncertain whether there is a difference for most outcomes. No data were reported for major adverse cardiovascular events (MACE). Cardiovascular (no bypass): 6 RCTs (372 participants) Moderate-certainty evidence suggests there is probably a reduction in risk of allogeneic transfusion with CS (RR 0.82, 95% CI 0.69 to 0.97; 3 RCTs, 169 participants). Very low- to low-certainty evidence means we are uncertain whether there is a difference for volume transfused, blood loss, mortality, re-operation for bleeding, infection, wound complication, myocardial infarction (MI), stroke, and hospital length of stay (LOS). There were no analysable data reported for thrombosis, DVT, pulmonary embolism (PE), and MACE. Cardiovascular (with bypass): 29 RCTs (2936 participants) Low-certainty evidence suggests there may be a reduction in the risk of allogeneic transfusion with CS, and suggests there may be no difference in risk of infection and hospital LOS. Very low- to moderate-certainty evidence means we are uncertain whether there is a reduction in volume transfused because of CS, or if there is any difference for mortality, blood loss, re-operation for bleeding, wound complication, thrombosis, DVT, PE, MACE, and MI, and probably no difference in risk of stroke. Obstetrics: 1 RCT (1356 participants) High-certainty evidence shows there is no difference between groups for mean volume of allogeneic blood transfused (mean difference (MD) -0.02 units, 95% CI -0.08 to 0.04; 1 RCT, 1349 participants). Low-certainty evidence suggests there may be no difference for risk of allogeneic transfusion. There were no analysable data reported for the remaining outcomes. Orthopaedic (hip only): 17 RCTs (2055 participants) Very low-certainty evidence means we are uncertain if CS reduces the risk of allogeneic transfusion, and the volume transfused, or if there is any difference between groups for mortality, blood loss, re-operation for bleeding, infection, wound complication, prosthetic joint infection (PJI), thrombosis, DVT, PE, stroke, and hospital LOS. There were no analysable data reported for MACE and MI. Orthopaedic (knee only): 26 RCTs (2568 participants) Very low- to low-certainty evidence means we are uncertain if CS reduces the risk of allogeneic transfusion, and the volume transfused, and whether there is a difference for blood loss, re-operation for bleeding, infection, wound complication, PJI, DVT, PE, MI, MACE, stroke, and hospital LOS. There were no analysable data reported for mortality and thrombosis. Orthopaedic (spine only): 6 RCTs (404 participants) Moderate-certainty evidence suggests there is probably a reduction in the need for allogeneic transfusion with CS (RR 0.44, 95% CI 0.31 to 0.63; 3 RCTs, 194 participants). Very low- to moderate-certainty evidence suggests there may be no difference for volume transfused, blood loss, infection, wound complication, and PE. There were no analysable data reported for mortality, re-operation for bleeding, PJI, thrombosis, DVT, MACE, MI, stroke, and hospital LOS. Orthopaedic (mixed): 14 RCTs (4374 participants) Very low- to low-certainty evidence means we are uncertain if there is a reduction in the need for allogeneic transfusion with CS, or if there is any difference between groups for volume transfused, mortality, blood loss, infection, wound complication, PJI, thrombosis, DVT, MI, and hospital LOS. There were no analysable data reported for re-operation for bleeding, MACE, and stroke.

Authors' conclusions: In some types of elective surgery, cell salvage may reduce the need for and volume of allogeneic transfusion, alongside evidence of no difference in adverse events, when compared to no cell salvage. Further research is required to establish why other surgeries show no benefit from CS, through further analysis of the current evidence. More large RCTs in under-reported specialities are needed to expand the evidence base for exploring the impact of CS.

PubMed Disclaimer

Conflict of interest statement

Tom D Lloyd (TDL): none known

Louise J Geneen (LJG): none known

Keeley Bernhardt (KB): none known

William McClune (WM): none known

Scott J Fernquest (SJF): none known

Tamara Brown (TB): none known

Carolyn Dorée (CD): none known

Susan J Brunskill (SJB): none. SJB is a Cochrane editor (with Cochrane Haematology) and was not involved with the editorial process for this review.

Michael F Murphy (MFM): MFM is in receipt of consulting fees as a Member of the Scientific Advisory Council from Haemonetics Corporation. However, MFM was not involved in the extraction, assessment of bias, or analysis of this review.

Antony JR Palmer (AJRP): none known

Figures

1
1
Study flow diagram. The Niranjan 2006 study reported for both on‐cardiopulmonary bypass and off‐cardiopulmonary bypass, and so is counted in both "with bypass" and "no bypass" groups.
2
2
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
3
3
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
4
4
1.1
1.1. Analysis
Comparison 1: All surgeries, Outcome 1: Transfusions
1.2
1.2. Analysis
Comparison 1: All surgeries, Outcome 2: Transfusions (sensitivity: registration)
1.3
1.3. Analysis
Comparison 1: All surgeries, Outcome 3: Transfusions (sensitivity: low risk of bias (ROB))
1.4
1.4. Analysis
Comparison 1: All surgeries, Outcome 4: Transfusions (subgroup: timing)
1.5
1.5. Analysis
Comparison 1: All surgeries, Outcome 5: Transfusions (subgroup: transfusion threshold)
2.1
2.1. Analysis
Comparison 2: Cancer (subgroup: timing), Outcome 1: Mortality
2.2
2.2. Analysis
Comparison 2: Cancer (subgroup: timing), Outcome 2: Blood loss (mL)
2.3
2.3. Analysis
Comparison 2: Cancer (subgroup: timing), Outcome 3: Infection
2.4
2.4. Analysis
Comparison 2: Cancer (subgroup: timing), Outcome 4: Deep vein thrombosis (DVT)
3.1
3.1. Analysis
Comparison 3: Cancer (subgroup: transfusion threshold), Outcome 1: Mortality
3.2
3.2. Analysis
Comparison 3: Cancer (subgroup: transfusion threshold), Outcome 2: Blood loss (mL)
3.3
3.3. Analysis
Comparison 3: Cancer (subgroup: transfusion threshold), Outcome 3: Infection
3.4
3.4. Analysis
Comparison 3: Cancer (subgroup: transfusion threshold), Outcome 4: Deep vein thrombosis (DVT)
4.1
4.1. Analysis
Comparison 4: Cardiovascular (vascular) (subgroup: timing), Outcome 1: Transfusions
4.2
4.2. Analysis
Comparison 4: Cardiovascular (vascular) (subgroup: timing), Outcome 2: Volume of transfusion (units) (PPR)
4.3
4.3. Analysis
Comparison 4: Cardiovascular (vascular) (subgroup: timing), Outcome 3: Volume of transfusion (units) (PPT)
4.4
4.4. Analysis
Comparison 4: Cardiovascular (vascular) (subgroup: timing), Outcome 4: Mortality
4.5
4.5. Analysis
Comparison 4: Cardiovascular (vascular) (subgroup: timing), Outcome 5: Blood loss (mL)
4.6
4.6. Analysis
Comparison 4: Cardiovascular (vascular) (subgroup: timing), Outcome 6: Reoperation for bleeding
4.7
4.7. Analysis
Comparison 4: Cardiovascular (vascular) (subgroup: timing), Outcome 7: Infection
4.8
4.8. Analysis
Comparison 4: Cardiovascular (vascular) (subgroup: timing), Outcome 8: Wound complication
4.9
4.9. Analysis
Comparison 4: Cardiovascular (vascular) (subgroup: timing), Outcome 9: Thrombosis (VTE)
4.10
4.10. Analysis
Comparison 4: Cardiovascular (vascular) (subgroup: timing), Outcome 10: DVT
4.11
4.11. Analysis
Comparison 4: Cardiovascular (vascular) (subgroup: timing), Outcome 11: PE
4.12
4.12. Analysis
Comparison 4: Cardiovascular (vascular) (subgroup: timing), Outcome 12: MI
4.13
4.13. Analysis
Comparison 4: Cardiovascular (vascular) (subgroup: timing), Outcome 13: CVA (stroke)
4.14
4.14. Analysis
Comparison 4: Cardiovascular (vascular) (subgroup: timing), Outcome 14: Hospital LOS (days)
5.1
5.1. Analysis
Comparison 5: Cardiovascular (vascular) (subgroup: transfusion threshold), Outcome 1: Transfusions
5.2
5.2. Analysis
Comparison 5: Cardiovascular (vascular) (subgroup: transfusion threshold), Outcome 2: Volume of transfusion (units) (PPR)
5.3
5.3. Analysis
Comparison 5: Cardiovascular (vascular) (subgroup: transfusion threshold), Outcome 3: Volume of transfusion (units) (PPT)
5.4
5.4. Analysis
Comparison 5: Cardiovascular (vascular) (subgroup: transfusion threshold), Outcome 4: Mortality
5.5
5.5. Analysis
Comparison 5: Cardiovascular (vascular) (subgroup: transfusion threshold), Outcome 5: Blood loss (mL)
5.6
5.6. Analysis
Comparison 5: Cardiovascular (vascular) (subgroup: transfusion threshold), Outcome 6: Reoperation for bleeding
5.7
5.7. Analysis
Comparison 5: Cardiovascular (vascular) (subgroup: transfusion threshold), Outcome 7: Infection
5.8
5.8. Analysis
Comparison 5: Cardiovascular (vascular) (subgroup: transfusion threshold), Outcome 8: Wound complication
5.9
5.9. Analysis
Comparison 5: Cardiovascular (vascular) (subgroup: transfusion threshold), Outcome 9: Thrombosis (VTE)
5.10
5.10. Analysis
Comparison 5: Cardiovascular (vascular) (subgroup: transfusion threshold), Outcome 10: DVT
5.11
5.11. Analysis
Comparison 5: Cardiovascular (vascular) (subgroup: transfusion threshold), Outcome 11: PE
5.12
5.12. Analysis
Comparison 5: Cardiovascular (vascular) (subgroup: transfusion threshold), Outcome 12: MI
5.13
5.13. Analysis
Comparison 5: Cardiovascular (vascular) (subgroup: transfusion threshold), Outcome 13: CVA (stroke)
5.14
5.14. Analysis
Comparison 5: Cardiovascular (vascular) (subgroup: transfusion threshold), Outcome 14: Hospital LOS (days)
6.1
6.1. Analysis
Comparison 6: Cardiovascular (no bypass) (subgroup: timing), Outcome 1: Transfusions
6.2
6.2. Analysis
Comparison 6: Cardiovascular (no bypass) (subgroup: timing), Outcome 2: Volume of transfusion (units) (PPR)
6.3
6.3. Analysis
Comparison 6: Cardiovascular (no bypass) (subgroup: timing), Outcome 3: Volume of transfusion (units) (PPT)
6.4
6.4. Analysis
Comparison 6: Cardiovascular (no bypass) (subgroup: timing), Outcome 4: Mortality
6.5
6.5. Analysis
Comparison 6: Cardiovascular (no bypass) (subgroup: timing), Outcome 5: Blood loss (mL)
6.6
6.6. Analysis
Comparison 6: Cardiovascular (no bypass) (subgroup: timing), Outcome 6: Reoperation for bleeding
6.7
6.7. Analysis
Comparison 6: Cardiovascular (no bypass) (subgroup: timing), Outcome 7: Infection
6.8
6.8. Analysis
Comparison 6: Cardiovascular (no bypass) (subgroup: timing), Outcome 8: Wound complication
6.9
6.9. Analysis
Comparison 6: Cardiovascular (no bypass) (subgroup: timing), Outcome 9: MI
6.10
6.10. Analysis
Comparison 6: Cardiovascular (no bypass) (subgroup: timing), Outcome 10: CVA (stroke)
6.11
6.11. Analysis
Comparison 6: Cardiovascular (no bypass) (subgroup: timing), Outcome 11: Hospital LOS (days)
7.1
7.1. Analysis
Comparison 7: Cardiovascular (no bypass) (subgroup: transfusion threshold), Outcome 1: Transfusions
7.2
7.2. Analysis
Comparison 7: Cardiovascular (no bypass) (subgroup: transfusion threshold), Outcome 2: Volume of transfusion (units) (PPR)
7.3
7.3. Analysis
Comparison 7: Cardiovascular (no bypass) (subgroup: transfusion threshold), Outcome 3: Volume of transfusion (units) (PPT)
7.4
7.4. Analysis
Comparison 7: Cardiovascular (no bypass) (subgroup: transfusion threshold), Outcome 4: Mortality
7.5
7.5. Analysis
Comparison 7: Cardiovascular (no bypass) (subgroup: transfusion threshold), Outcome 5: Blood loss (mL)
7.6
7.6. Analysis
Comparison 7: Cardiovascular (no bypass) (subgroup: transfusion threshold), Outcome 6: Reoperation for bleeding
7.7
7.7. Analysis
Comparison 7: Cardiovascular (no bypass) (subgroup: transfusion threshold), Outcome 7: Infection
7.8
7.8. Analysis
Comparison 7: Cardiovascular (no bypass) (subgroup: transfusion threshold), Outcome 8: Wound complication
7.9
7.9. Analysis
Comparison 7: Cardiovascular (no bypass) (subgroup: transfusion threshold), Outcome 9: MI
7.10
7.10. Analysis
Comparison 7: Cardiovascular (no bypass) (subgroup: transfusion threshold), Outcome 10: CVA (stroke)
7.11
7.11. Analysis
Comparison 7: Cardiovascular (no bypass) (subgroup: transfusion threshold), Outcome 11: Hospital LOS (days)
8.1
8.1. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 1: Transfusions
8.2
8.2. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 2: Volume of transfusion (units) (PPR)
8.3
8.3. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 3: Volume of transfusion (units) (PPT)
8.4
8.4. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 4: Mortality
8.5
8.5. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 5: Blood loss (mL)
8.6
8.6. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 6: Reoperation for bleeding
8.7
8.7. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 7: Infection
8.8
8.8. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 8: Wound complication
8.9
8.9. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 9: Thrombosis (VTE)
8.10
8.10. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 10: DVT
8.11
8.11. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 11: PE
8.12
8.12. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 12: MACE
8.13
8.13. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 13: MI
8.14
8.14. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 14: CVA (stroke)
8.15
8.15. Analysis
Comparison 8: Cardiovascular (with bypass) (subgroup: timing), Outcome 15: Hospital LOS (days)
9.1
9.1. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 1: Transfusions
9.2
9.2. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 2: Volume of transfusion (units) (PPR)
9.3
9.3. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 3: Volume of transfusion (units) (PPT)
9.4
9.4. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 4: Mortality
9.5
9.5. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 5: Blood loss (mL)
9.6
9.6. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 6: Reoperation for bleeding
9.7
9.7. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 7: Infection
9.8
9.8. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 8: Wound complication
9.9
9.9. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 9: Thrombosis (VTE)
9.10
9.10. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 10: DVT
9.11
9.11. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 11: PE
9.12
9.12. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 12: MACE
9.13
9.13. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 13: MI
9.14
9.14. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 14: CVA (stroke)
9.15
9.15. Analysis
Comparison 9: Cardiovascular (with bypass) (subgroup: transfusion threshold), Outcome 15: Hospital LOS (days)
10.1
10.1. Analysis
Comparison 10: Obstetrics (subgroup: timing), Outcome 1: Transfusions
10.2
10.2. Analysis
Comparison 10: Obstetrics (subgroup: timing), Outcome 2: Volume of transfusion (units) (PPR)
10.3
10.3. Analysis
Comparison 10: Obstetrics (subgroup: timing), Outcome 3: Volume of transfusion (units) (PPT)
11.1
11.1. Analysis
Comparison 11: Obstetrics (subgroup: transfusion threshold), Outcome 1: Transfusions
11.2
11.2. Analysis
Comparison 11: Obstetrics (subgroup: transfusion threshold), Outcome 2: Volume of transfusion (units) (PPR)
11.3
11.3. Analysis
Comparison 11: Obstetrics (subgroup: transfusion threshold), Outcome 3: Volume of transfusion (units) (PPT)
12.1
12.1. Analysis
Comparison 12: Orthopaedic (hip) (subgroup: timing), Outcome 1: Transfusions
12.2
12.2. Analysis
Comparison 12: Orthopaedic (hip) (subgroup: timing), Outcome 2: Volume of transfusion (units) (PPR)
12.3
12.3. Analysis
Comparison 12: Orthopaedic (hip) (subgroup: timing), Outcome 3: Volume of transfusion (units) (PPT)
12.4
12.4. Analysis
Comparison 12: Orthopaedic (hip) (subgroup: timing), Outcome 4: Mortality
12.5
12.5. Analysis
Comparison 12: Orthopaedic (hip) (subgroup: timing), Outcome 5: Blood loss (mL)
12.6
12.6. Analysis
Comparison 12: Orthopaedic (hip) (subgroup: timing), Outcome 6: Reoperation for bleeding
12.7
12.7. Analysis
Comparison 12: Orthopaedic (hip) (subgroup: timing), Outcome 7: Infection
12.8
12.8. Analysis
Comparison 12: Orthopaedic (hip) (subgroup: timing), Outcome 8: Wound complication
12.9
12.9. Analysis
Comparison 12: Orthopaedic (hip) (subgroup: timing), Outcome 9: Prosthetic joint infection (PJI)
12.10
12.10. Analysis
Comparison 12: Orthopaedic (hip) (subgroup: timing), Outcome 10: Thrombosis (VTE)
12.11
12.11. Analysis
Comparison 12: Orthopaedic (hip) (subgroup: timing), Outcome 11: DVT
12.12
12.12. Analysis
Comparison 12: Orthopaedic (hip) (subgroup: timing), Outcome 12: PE
12.13
12.13. Analysis
Comparison 12: Orthopaedic (hip) (subgroup: timing), Outcome 13: CVA (stroke)
12.14
12.14. Analysis
Comparison 12: Orthopaedic (hip) (subgroup: timing), Outcome 14: Hospital LOS (days)
13.1
13.1. Analysis
Comparison 13: Orthopaedic (hip) (subgroup: transfusion threshold), Outcome 1: Transfusions
13.2
13.2. Analysis
Comparison 13: Orthopaedic (hip) (subgroup: transfusion threshold), Outcome 2: Volume of transfusion (units) (PPR)
13.3
13.3. Analysis
Comparison 13: Orthopaedic (hip) (subgroup: transfusion threshold), Outcome 3: Volume of transfusion (units) (PPT)
13.4
13.4. Analysis
Comparison 13: Orthopaedic (hip) (subgroup: transfusion threshold), Outcome 4: Mortality
13.5
13.5. Analysis
Comparison 13: Orthopaedic (hip) (subgroup: transfusion threshold), Outcome 5: Blood loss (mL)
13.6
13.6. Analysis
Comparison 13: Orthopaedic (hip) (subgroup: transfusion threshold), Outcome 6: Reoperation for bleeding
13.7
13.7. Analysis
Comparison 13: Orthopaedic (hip) (subgroup: transfusion threshold), Outcome 7: Infection
13.8
13.8. Analysis
Comparison 13: Orthopaedic (hip) (subgroup: transfusion threshold), Outcome 8: Wound complication
13.9
13.9. Analysis
Comparison 13: Orthopaedic (hip) (subgroup: transfusion threshold), Outcome 9: Prosthetic joint infection (PJI)
13.10
13.10. Analysis
Comparison 13: Orthopaedic (hip) (subgroup: transfusion threshold), Outcome 10: Thrombosis (VTE)
13.11
13.11. Analysis
Comparison 13: Orthopaedic (hip) (subgroup: transfusion threshold), Outcome 11: DVT
13.12
13.12. Analysis
Comparison 13: Orthopaedic (hip) (subgroup: transfusion threshold), Outcome 12: PE
13.13
13.13. Analysis
Comparison 13: Orthopaedic (hip) (subgroup: transfusion threshold), Outcome 13: CVA (stroke)
13.14
13.14. Analysis
Comparison 13: Orthopaedic (hip) (subgroup: transfusion threshold), Outcome 14: Hospital LOS (days)
14.1
14.1. Analysis
Comparison 14: Orthopaedic (knee) (subgroup: timing), Outcome 1: Transfusions
14.2
14.2. Analysis
Comparison 14: Orthopaedic (knee) (subgroup: timing), Outcome 2: Volume of transfusion (units) (PPR)
14.3
14.3. Analysis
Comparison 14: Orthopaedic (knee) (subgroup: timing), Outcome 3: Volume of transfusion (units) (PPT)
14.4
14.4. Analysis
Comparison 14: Orthopaedic (knee) (subgroup: timing), Outcome 4: Blood loss (ml)
14.5
14.5. Analysis
Comparison 14: Orthopaedic (knee) (subgroup: timing), Outcome 5: Reoperation for bleeding
14.6
14.6. Analysis
Comparison 14: Orthopaedic (knee) (subgroup: timing), Outcome 6: Infection
14.7
14.7. Analysis
Comparison 14: Orthopaedic (knee) (subgroup: timing), Outcome 7: Wound complication
14.8
14.8. Analysis
Comparison 14: Orthopaedic (knee) (subgroup: timing), Outcome 8: Prosthetic joint infection (PJI)
14.9
14.9. Analysis
Comparison 14: Orthopaedic (knee) (subgroup: timing), Outcome 9: DVT
14.10
14.10. Analysis
Comparison 14: Orthopaedic (knee) (subgroup: timing), Outcome 10: PE
14.11
14.11. Analysis
Comparison 14: Orthopaedic (knee) (subgroup: timing), Outcome 11: MACE
14.12
14.12. Analysis
Comparison 14: Orthopaedic (knee) (subgroup: timing), Outcome 12: MI
14.13
14.13. Analysis
Comparison 14: Orthopaedic (knee) (subgroup: timing), Outcome 13: CVA (stroke)
14.14
14.14. Analysis
Comparison 14: Orthopaedic (knee) (subgroup: timing), Outcome 14: Hospital LOS (days)
15.1
15.1. Analysis
Comparison 15: Orthopaedic (knee) (subgroup: transfusion threshold), Outcome 1: Transfusions
15.2
15.2. Analysis
Comparison 15: Orthopaedic (knee) (subgroup: transfusion threshold), Outcome 2: Volume of transfusion (units) (PPR)
15.3
15.3. Analysis
Comparison 15: Orthopaedic (knee) (subgroup: transfusion threshold), Outcome 3: Volume of transfusion (units) (PPT)
15.4
15.4. Analysis
Comparison 15: Orthopaedic (knee) (subgroup: transfusion threshold), Outcome 4: Blood loss (mL)
15.5
15.5. Analysis
Comparison 15: Orthopaedic (knee) (subgroup: transfusion threshold), Outcome 5: Reoperation for bleeding
15.6
15.6. Analysis
Comparison 15: Orthopaedic (knee) (subgroup: transfusion threshold), Outcome 6: Infection
15.7
15.7. Analysis
Comparison 15: Orthopaedic (knee) (subgroup: transfusion threshold), Outcome 7: Wound complication
15.8
15.8. Analysis
Comparison 15: Orthopaedic (knee) (subgroup: transfusion threshold), Outcome 8: Prosthetic joint infection (PJI)
15.9
15.9. Analysis
Comparison 15: Orthopaedic (knee) (subgroup: transfusion threshold), Outcome 9: DVT
15.10
15.10. Analysis
Comparison 15: Orthopaedic (knee) (subgroup: transfusion threshold), Outcome 10: PE
15.11
15.11. Analysis
Comparison 15: Orthopaedic (knee) (subgroup: transfusion threshold), Outcome 11: MACE
15.12
15.12. Analysis
Comparison 15: Orthopaedic (knee) (subgroup: transfusion threshold), Outcome 12: MI
15.13
15.13. Analysis
Comparison 15: Orthopaedic (knee) (subgroup: transfusion threshold), Outcome 13: CVA (stroke)
15.14
15.14. Analysis
Comparison 15: Orthopaedic (knee) (subgroup: transfusion threshold), Outcome 14: Hospital LOS (days)
16.1
16.1. Analysis
Comparison 16: Orthopaedic (spinal) (subgroup: timing), Outcome 1: Transfusions
16.2
16.2. Analysis
Comparison 16: Orthopaedic (spinal) (subgroup: timing), Outcome 2: Volume of transfusion (units) (PPR)
16.3
16.3. Analysis
Comparison 16: Orthopaedic (spinal) (subgroup: timing), Outcome 3: Volume of transfusion (units) (PPT)
16.4
16.4. Analysis
Comparison 16: Orthopaedic (spinal) (subgroup: timing), Outcome 4: Blood loss (mL)
16.5
16.5. Analysis
Comparison 16: Orthopaedic (spinal) (subgroup: timing), Outcome 5: Infection
16.6
16.6. Analysis
Comparison 16: Orthopaedic (spinal) (subgroup: timing), Outcome 6: Wound complication
16.7
16.7. Analysis
Comparison 16: Orthopaedic (spinal) (subgroup: timing), Outcome 7: PE
17.1
17.1. Analysis
Comparison 17: Orthopaedic (spinal) (subgroup: transfusion threshold), Outcome 1: Transfusions
17.2
17.2. Analysis
Comparison 17: Orthopaedic (spinal) (subgroup: transfusion threshold), Outcome 2: Volume of transfusion (units) (PPR)
17.3
17.3. Analysis
Comparison 17: Orthopaedic (spinal) (subgroup: transfusion threshold), Outcome 3: Volume of transfusion (units) (PPT)
17.4
17.4. Analysis
Comparison 17: Orthopaedic (spinal) (subgroup: transfusion threshold), Outcome 4: Blood loss (mL)
17.5
17.5. Analysis
Comparison 17: Orthopaedic (spinal) (subgroup: transfusion threshold), Outcome 5: Infection
17.6
17.6. Analysis
Comparison 17: Orthopaedic (spinal) (subgroup: transfusion threshold), Outcome 6: Wound complication
17.7
17.7. Analysis
Comparison 17: Orthopaedic (spinal) (subgroup: transfusion threshold), Outcome 7: PE
18.1
18.1. Analysis
Comparison 18: Orthopaedic (mixed) (subgroup: timing), Outcome 1: Transfusions
18.2
18.2. Analysis
Comparison 18: Orthopaedic (mixed) (subgroup: timing), Outcome 2: Volume of transfusion (units) (PPR)
18.3
18.3. Analysis
Comparison 18: Orthopaedic (mixed) (subgroup: timing), Outcome 3: Volume of transfusion (units) (PPT)
18.4
18.4. Analysis
Comparison 18: Orthopaedic (mixed) (subgroup: timing), Outcome 4: Mortality
18.5
18.5. Analysis
Comparison 18: Orthopaedic (mixed) (subgroup: timing), Outcome 5: Blood loss (mL)
18.6
18.6. Analysis
Comparison 18: Orthopaedic (mixed) (subgroup: timing), Outcome 6: Infection
18.7
18.7. Analysis
Comparison 18: Orthopaedic (mixed) (subgroup: timing), Outcome 7: Wound complication
18.8
18.8. Analysis
Comparison 18: Orthopaedic (mixed) (subgroup: timing), Outcome 8: Prosthetic joint infection (PJI)
18.9
18.9. Analysis
Comparison 18: Orthopaedic (mixed) (subgroup: timing), Outcome 9: Thrombosis (VTE)
18.10
18.10. Analysis
Comparison 18: Orthopaedic (mixed) (subgroup: timing), Outcome 10: DVT
18.11
18.11. Analysis
Comparison 18: Orthopaedic (mixed) (subgroup: timing), Outcome 11: PE
18.12
18.12. Analysis
Comparison 18: Orthopaedic (mixed) (subgroup: timing), Outcome 12: MI
18.13
18.13. Analysis
Comparison 18: Orthopaedic (mixed) (subgroup: timing), Outcome 13: Hospital LOS (days)
19.1
19.1. Analysis
Comparison 19: Orthopaedic (mixed) (subgroup: transfusion threshold), Outcome 1: Transfusions
19.2
19.2. Analysis
Comparison 19: Orthopaedic (mixed) (subgroup: transfusion threshold), Outcome 2: Volume of transfusion (units) (PPR)
19.3
19.3. Analysis
Comparison 19: Orthopaedic (mixed) (subgroup: transfusion threshold), Outcome 3: Volume of transfusion (units) (PPT)
19.4
19.4. Analysis
Comparison 19: Orthopaedic (mixed) (subgroup: transfusion threshold), Outcome 4: Mortality
19.5
19.5. Analysis
Comparison 19: Orthopaedic (mixed) (subgroup: transfusion threshold), Outcome 5: Blood loss (mL)
19.6
19.6. Analysis
Comparison 19: Orthopaedic (mixed) (subgroup: transfusion threshold), Outcome 6: Infection
19.7
19.7. Analysis
Comparison 19: Orthopaedic (mixed) (subgroup: transfusion threshold), Outcome 7: Wound complication
19.8
19.8. Analysis
Comparison 19: Orthopaedic (mixed) (subgroup: transfusion threshold), Outcome 8: Prosthetic joint infection (PJI)
19.9
19.9. Analysis
Comparison 19: Orthopaedic (mixed) (subgroup: transfusion threshold), Outcome 9: Thrombosis (VTE)
19.10
19.10. Analysis
Comparison 19: Orthopaedic (mixed) (subgroup: transfusion threshold), Outcome 10: DVT
19.11
19.11. Analysis
Comparison 19: Orthopaedic (mixed) (subgroup: transfusion threshold), Outcome 11: PE
19.12
19.12. Analysis
Comparison 19: Orthopaedic (mixed) (subgroup: transfusion threshold), Outcome 12: MI
19.13
19.13. Analysis
Comparison 19: Orthopaedic (mixed) (subgroup: transfusion threshold), Outcome 13: Hospital LOS (days)
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Abuzakuk 2007 {published data only}
    1. Abuzakuk T, Senthil KV, Shenava Y, Bulstrode C, Skinner JA, Cannon SR, et al. Autotransfusion drains in total knee replacement. Are they alternatives to homologous transfusion? International Orthopaedics 2007;31(2):235-9. - PMC - PubMed
Adalberth 1998 {published data only}
    1. Adalberth G, Bystrom S, Kolstad K, Mallmin H, Milbrink J. Postoperative drainage of knee arthroplasty is not necessary - A randomised study of 90 patients. Acta Orthopaedica Scandinavica 1998;69(5):475-8. - PubMed
Adan 1988 {published data only}
    1. Adan A, la Rivière AB, Haas F, Zalk A, Nooij E. Autotransfusion of drained mediastinal blood after cardiac surgery: a reappraisal. Thoracic and Cardiovascular Surgery 1988;36(1):10-14. - PubMed
Altinel 2007 {published data only}
    1. Altinel L, Kaya E, Kose KC, Fidan F, Ergan V, Fidan H. Effect of shed blood retransfusion on pulmonary perfusion after total knee arthroplasty: a prospective controlled study. International Orthopaedics 2007;31(6):837-44. - PMC - PubMed
Amin 2008 {published data only}
    1. Amin A, Watson A, Mangwani J, Nawabi D, Ahluwalia R, Loeffler M. A prospective randomised controlled trial of autologous retransfusion in total knee replacement. Journal of Bone & Joint Surgery. British Volume 2008;90(4):451-4. - PubMed
Atay 2010 {published data only (unpublished sought but not used)}
    1. Atay EF, Güven M, Altinaş F, Kadioğlu B, Ceviz E, Ipek S. Allogeneic blood transfusion decreases with postoperative autotransfusion in hip and knee arthroplasty. Acta Orthopaedica et Traumatologica Turcica 2010;44(4):306-12. [DOI: 10.3944/AOTT.2010.2417] - DOI - PubMed
Axford 1994 {published data only}
    1. Axford TC, Dearani JA, Ragno G, MacGregor H, Patel MA, Valeri CR, et al. Safety and therapeutic effectiveness of reinfused shed blood after open heart surgery. Annals of Thoracic Surgery 1994;57(3):615-22. - PubMed
Ayers 1995 {published data only}
    1. Ayers DC, Murray DG, Duerr DM. Blood salvage after total hip arthroplasty. Journal of Bone and Joint Surgery. American Volume 1995;77(9):1347-51. - PubMed
Blatsoukas 2010 {published data only}
    1. Blatsoukas KS, Drosos GI, Kazakos K, Papaioakim M, Gioka T, Chloropoulou P, et al. Prospective comparative study of two different autotransfusion methods versus control group in total knee replacement. Archives of Orthopaedic and Trauma Surgery 2010;130:733-37. - PubMed
Breakwell 2000 {published data only}
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Cheng 2005 {published data only}
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Cheung 2010 {published data only}
    1. Cheung G, Carmont MR, Bing AJF, Kuiper JH, Alcock RJ, Graham NM. No drain, autologous transfusion drain or suction drain? A randomised prospective study in total hip replacement surgery of 168 patients. Acta Orthopaedica Belgica 2010;76:619-27. - PubMed
    1. ISRCTN71177341. The role of reinfusion drains in reducing transfusion requirements following primary total hip arthroplasty. www.isrctn.com/ISRCTN71177341 Submission date: 29 September 2006; Registration date: 29 September 2006 (retrospective). [DOI: ]
Cip 2013 {published data only}
    1. Cip J, Widemschek M, Benesch T, Waibel R, Martin A. Does single use of an autologous transfusion system in TKA reduce the need for allogenic blood? A prospective randomized trial. Clinical Orthopaedics and Related Research 2013;471:1319-25. - PMC - PubMed
Clagett 1999 {published data only}
    1. Clagett GP, Valentine RJ, Jackson MR, Mathison C, Kakish HB, Bengtson TD. A randomised trial of intraoperative autotransfusion during aortic surgery. Journal of Vascular Surgery 1999;29(1):22-31. - PubMed
Dalrymple‐Hay 1999 {published data only}
    1. Dalrymple-Hay MJ, Pack L, Deakin CD, Shepherd S, Ohri SK, Haw MP, et al. Autotransfusion of washed shed mediastinal fluid decreases requirement for autologous blood transfusion following cardiac surgery: a prospective randomized trial. European Journal of Cardio-thoracic Surgery 1999;15:830-4. - PubMed
    1. Dalrymple-Hay MJR, Dawkins S, Pack L, Deakin CD, Sheppard S, Ohri SK, et al. Autotransfusion decreases blood usage following cardiac surgery - A prospective randomized trial. Cardiovascular Surgery 2001;9(2):184-7. - PubMed
Damgaard 2006 {published data only}
    1. Damgaard S, Steinbruchel DA. Autotransfusion with cell saver for off-pump coronary artery bypass surgery: a randomized trial. Scandinavian Cardiovascular Journal 2006;40(3):194-8. - PubMed
Davies 1987 {published data only}
    1. Davies MJ, Cronin KC, Moran P, Mears L, Booth RJ. Autologous blood transfusion for major vascular surgery using the Sorenson Receptal Device. Anaesthesia and Intensive Care 1987;15(3):282-8. - PubMed
Djurasovic 2018 {published data only}
    1. Djurasovic M, McGraw KE, Bratcher K, Crawford CH, Dimar JR, Puno RM, et al. Randomized trial of Cell Saver in 2- to 3-level lumbar instrumented posterior fusions. Journal of Neurosurgery Spine 2018;29:582-7. - PubMed
    1. NCT01453309. Cost effectiveness and clinical utility of cell saver use for two to three level lumbar fusions. clinicaltrials.gov/ct2/show/NCT01453309 First posted: 17 October 2011 (prospective).
    1. Ogura Y, Dimar JR, Gum JL, Crawford CH, Djurasovic M, Glassman SD, et al. Hidden blood loss following 2- to 3-level posterior lumbar fusion. Spine Journal: Official Journal of the North American Spine Society 2019;19 (12):P2003-6. [DOI: 10.1016/j.spinee.2019.07.010] - DOI - PubMed
Dramis 2006 {published data only}
    1. Dramis A, Plewes J. Autologous blood transfusion after primary unilateral total knee replacement surgery. Acta Orthopaedica Belgica 2006;72(1):15-7. - PubMed
Dutton 2012 {published data only}
    1. Dutton T, De Souza R, Parsons N, Costa ML. The timing of tourniquet release and ‘retransfusion’ drains in total knee arthroplasty: a stratified randomised pilot investigation. Knee 2012;19:190-2. - PubMed
Ekback 1995 {published data only}
    1. Ekback G, Schott U, Axelsson K, Carberg M. Perioperative autotransfusion and functional coagulation analysis in total hip replacement. Acta Anaesthesiologica Scandinavica 1995;39:390-5. [MEDLINE: ] - PubMed
Elawad 1991 {published data only}
    1. Elawad AA, Ohlin AK, Berntorp E, Nilsson IM, Fredin H. Intraoperative autotransfusion in primary hip arthroplasty. A randomized comparison with homologous blood. Acta Orthopaedica Scandinavica 1991;62(6):557-62. - PubMed
Eng 1990 {published data only}
    1. Eng J, Kay PH, Murday AJ, Shreiti I, Harrison DP, Norfolk DR, et al. Postoperative autologous transfusion in cardiac surgery. A prospective, randomised study. European Journal of Cardiothorac Surgery 1990;4(11):595-600. - PubMed
Feiner 2015 {published data only}
    1. Feiner JR, Gropper MA, Toy P, Lieberman J, Twiford J, Weiskopf RB. A clinical trial to detect subclinical transfusion-induced lung injury during surgery. Anaesthesiology 2015;123(1):126-35. - PMC - PubMed
Gäbel 2013a {published data only}
    1. Gäbel J, Hakimi CS, Westerberg M, Radulovic V, Jeppsson A. Retransfusion of cardiotomy suction blood impairs haemostasis: ex vivo and in vivo studies. Scandinavian Cardiovascular Journal 2013;47:368-76. - PubMed
Galaal 2019 (TIC TOC) {published data only}
    1. Galaal K, Lopes A, Pritchard C, Barton A, Wingham J, Marques EM, et al. Trial of intraoperative cell salvage versus transfusion in ovarian cancer (TIC TOC): a multi-centre randomised controlled feasibility study. International Journal of Gynaecological Cancer 2019;29 (Supp 4):A33. [DOI: 10.1136/ijgc-2019-ESGO.34] - DOI
    1. Galaal K, Lopes A, Pritchard C, Barton A, Wingham J, Marques EMR, et al. Trial of intraoperative cell salvage versus transfusion in ovarian cancer (TIC TOC): protocol for a randomised controlled feasibility study. BMJ Open 2018;8(11):e024108. [DOI: 10.1136/bmjopen-2018-024108] - DOI - PMC - PubMed
    1. ISRCTN19517317. Intraoperative cell salvage vs transfusion in ovarian cancer. www.isrctn.com/ISRCTN19517317 Submission date: 07 November 2016. Registration date: 11 November 2016 (prospective). [DOI: 10.1186/ISRCTN19517317] - DOI
Gannon 1991 {published data only}
    1. Gannon DM, Lombardi AV Jr, Mallory TH, Vaughn BK, Finney, CR, Niemcryk S. An evaluation of the efficacy of postoperative blood salvage after total joint arthroplasty. A prospective randomized trial. Journal of Arthroplasty 1991;6(2):109-14. - PubMed
Goel 2007 {published data only}
    1. Goel P, Pannu H, Mohan D, Arora R. Efficacy of cell saver in reducing homologous blood transfusions during OPCAB surgery: a prospective randomized trial. Transfusion Medicine 2007;17(4):285-9. - PubMed
Healy 1994 {published data only}
    1. Healy WL, Pfeifer BA, Kurtz SR, Johnson C, Johnson W, Johnston R, et al. Evaluation of autologous shed blood for autotransfusion after orthopaedic surgery. Clinical Orthopaedics and Related Research 1994;299:53-9. - PubMed
Heddle 1992 {published data only}
    1. Heddle NM, Brox WT, Klama LL, Dickson LL, Levine MN. A randomized trial on the efficacy of an autologous blood drainage and transfusion device in patients undergoing elective knee arthroplasty. Transfusion 1992;32:742-6. - PubMed
Horstmann 2012 {published data only}
    1. Horstmann WG, Kuipers BM, Slappendel R, Castelein RM, Kollen BJ, Verheyen CC. Postoperative autologous blood transfusion drain or no drain in primary total hip arthroplasty? A randomised controlled trial. International Orthopaedics 2012;36(10):2033-9. [DOI: 10.1007/s00264-012-1613-7] - DOI - PMC - PubMed
Horstmann 2013 {published data only}
    1. Horstmann WG, Swierstra MJ, Ohanis D, Castelein RM, Kollen BJ, Verheyen CC. Reduction of blood loss with the use of a new combined intra-operative and post-operative autologous blood transfusion system compared with no drainage in primary total hip replacement. Bone and Joint Journal 2013;95-B(5):616-22. [DOI: 10.1302/0301-620X.95B5.30472] - DOI - PubMed
Horstmann 2014a {published data only}
    1. Horstmann WG, Swierstra MJ, Ohanis D, Rolink R, Kollen BJ, Verheyen CC. Favourable results of a new intraoperative and postoperative filtered autologous blood re-transfusion system in total hip arthroplasty: a randomised controlled trial. International Orthopaedics 2014;38(1):13-18. [DOI: 10.1007/s00264-013-2084-1] - DOI - PMC - PubMed
Horstmann 2014b {published data only}
    1. Horstmann W, Kuipers B, Ohanis D, Slappendel R, Kollen B, Verheyen C. Autologous re-transfusion drain compared with no drain in total knee arthroplasty: a randomised controlled trial. Blood Transfusion 2014;12(Suppl 1):S176-81. [DOI: ] - PMC - PubMed
Jacobi 1997 {published data only}
    1. Jacobi K, Walther A, Kuhn R, Dworak O, Neidhardt B, Rugheimer E. Advantages and limitations of intraoperative mechanical autotransfusion in radical prostatectomies. Anaesthetist 1997;46(2):101-7. - PubMed
Kelley‐Patteson 1993 {published data only}
    1. Kelley-Patteson C, Ammar AD, Kelley H. Should the Cell Saver Autotransfusion Device be used routinely in all infrarenal abdominal aortic bypass operations? Journal of Vascular Surgery 1993;18(2):261-5. - PubMed
Khan 2017 (SALVO) {published data only}
    1. Geoghegan J, Middleton L, Moore P, Subseson G, Khan K, Daniels J. Routine cell salvage during elective caesarean section: a pilot randomised trial. International Journal of Obstetric Anesthesia 2015;24(1):86-7. [DOI: 10.1016/j.ijoa.2014.08.003] - DOI - PubMed
    1. ISRCTN66118656. Cell salvage in obstetrics. www.isrctn.com/ISRCTN66118656 Submission date: 18 June 2012. Registration date: 25 June 2012 (prospective).
    1. Khan KS, Moore PAS, Wilson MJ, Hooper R, Allard S, Wrench I, et al, on behalf of the SALVO study group. Cell salvage and donor blood transfusion during cesarean section: a pragmatic, multicentre randomised controlled trial (SALVO). PLoS Medicine 2017;14(12):e1002471. [DOI: 10.1371/journal.pmed.1002471] - DOI - PMC - PubMed
Kirkos 2006 {published data only}
    1. Kirkos JM, Krystallis CT, Konstantinidis PA, Papavasiliou KA, Kyrkos MJ, Ikonomidis LG. Postoperative re-perfusion of drained blood in patients undergoing total knee arthroplasty: is it effective and cost-efficient? Acta Orthopaedica Belgica 2006;72(1):18-23. - PubMed
Klein 2008 {published data only}
    1. Klein AA, Nashef SA, Sharples L, Bottrill F, Dyer M, Armstrong J, et al. A randomized controlled trial of cell salvage in routine cardiac surgery. Anesthesia and Analgesia 2008;107(5):1487-95. - PubMed
Kleinert 2012 {published data only}
    1. Kleinert K, Werner C, Mamisch-Saupe N, Kalberer F, Dora C. Closed suction drainage with or without re-transfusion of filtered shed blood does not offer advantages in primary non-cemented total hip replacement using a direct anterior approach. Archives of Orthopaedic and Trauma Surgery 2012;132(1):131-6. [DOI: 10.1007/s00402-011-1387-1] - DOI - PubMed
Koopman‐van Gemert 1993a {published data only}
    1. Koopman-van Germert AW. Chapter 5: Processed autotransfusion and homologous red cell requirement in elective cardiac and orthopaedic surgery: a randomised prospective study. In: Peri-operative Autotransfusion by Means of a Blood Cell Separator [PhD thesis]. The Hague (Den Haag): Cip-Data Koninklijke Bibliotheek, 1993:96-112. [ISBN: 9090057552]
Koopman‐van Gemert 1993b {published data only}
    1. Koopman-van Germert AW. Chapter 5: Processed autotransfusion and homologous red cell requirement in elective cardiac and orthopaedic surgery: a randomised prospective study. In: Peri-operative Autotransfusion by Means of a Blood Cell Separator (PhD thesis). The Hague (Den Haag): Cip-Data Koninklijke Bibliotheek, 1993:96-112. [ISBN: 9090057552]
Kristensen 1992 {published data only}
    1. Kristensen PW, Sørensen LS, Thyregod HC. Autotransfusion of drainage blood in arthroplasty. A prospective, controlled study of 31 operations. Acta Orthopaedica Scandinavica 1992;63(4):377-80. - PubMed
Laszczyca 2015 {published data only}
    1. Łaszczyca M, Kusz D, Wojciechowski P, Szmigiel A, Wójcik M, Kusz M. Medical and economic advantages of postoperative blood salvage in total knee replacement [Ocena korzyści medycznych i ekonomicznych re transfuzji krwi z drenażu po aloplastyce kolana]. Ortopedia Traumatologia Rehabilitacja 2015;17(6):603-10. [DOI: 10.5604/15093492.1193017] - DOI - PubMed
Lepore 1989 {published data only}
    1. Lepore V, Radegran K. Autotransfusion of mediastinal blood in cardiac surgery. Scandinavian Journal of Thoracic and Cardiovascular Surgery 1989;23(1):47-9. - PubMed
Lorentz 1991 {published data only}
    1. Lorentz A, Osswald PM, Schilling M, Jani L. A comparison of autologous transfusion procedures in hip surgery. Anaesthesist 1991;40(4):205-13. - PubMed
Luo 2016 {published data only}
    1. Luo C, Luo X, He Y, Li J, Huang B, Lin L, et al. Impact of postoperative drainage autologous blood re-transfusion on the coagulation parameters and D-dimer levels of patients after total hip arthroplasty. Transfusion and Apheresis Science 2016;55(1):109-13. [DOI: 10.1016/j.transci.2016.04.001] - DOI - PubMed
Mac 1993 {published data only}
    1. Mac HL, Reynolds MA, Treston-Aurand J, Henke JA. Comparison of autoreinfusion and standard drainage systems in total joint arthroplasty patients. Orthopaedic Nursing 1993;12(3):19-25. - PubMed
Mah 1995 {published data only}
    1. Mah ET, Davis R, Seshadri P, Nyman TLM, Seshadri R. The role of autologous blood transfusion in joint replacement. Anaesthesia and Intensive Care 1995;23:472-7. - PubMed
Majkowski 1991 {published data only}
    1. Majkowski RS, Currie IC, Newman JH. Postoperative collection and reinfusion of autologous blood in total knee arthroplasty. Annals of the Royal College of Surgeons of England 1991;73(6):381-4. - PMC - PubMed
Marberg 2010 {published data only}
    1. Marberg H, Jeppsson A, Brandrup-Wognsen G. Postoperative autotransfusion of mediastinal shed blood does not influence haemostasis after elective coronary artery bypass grafting. European Journal of Cardio-Thoracic Surgery 2010;38(6):767-72. [DOI: 10.1016/j.ejcts.2010.03.043] - DOI - PubMed
Martin 2000 {published data only}
    1. Martin J, Robitaille D, Perrault LP, Pellerin M, Page P, Searle N et al. Reinfusion of mediastinal blood after heart surgery. Journal of Thoracic and Cardiovascular Surgery 2000;120(3):499-504. - PubMed
Mauerhan 1993 {published data only}
    1. Mauerhan DR, Nussman D, Mokris JG, Beaver WB. Effect of postoperative reinfusion systems on hemoglobin levels in primary total hip and total knee arthroplasties. A prospective randomized study. Journal of Arthroplasty 1993;8(5):523-7. - PubMed
McShane 1987 {published data only}
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Menges 1992 {published data only}
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Mercer 2004 {published data only}
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Moonen 2007 {published data only}
    1. Moonen AF, Knoors NT, Os JJ, Verburg AD, Pilot P. Retransfusion of filtered shed blood in primary total hip and knee arthroplasty: a prospective randomized clinical trial. Transfusion 2007;47(3):379-84. - PubMed
Munteanu 2009 {published data only}
    1. Munteanu AM. Efficacy of the methods to reduce the allogenic transfusion in primary knee arthroplasty. Jurnalul Roman de Anestezie Terapie Intensiva 2009;16(2):107-13.
Murphy 2005 {published data only}
    1. Murphy GJ, Rogers CS, Lansdowne WB, Channon I, Alwair H, Cohen A, et al. Safety, efficacy, and cost of intraoperative cell salvage and autotransfusion after off-pump coronary artery bypass surgery: a randomized trial. Journal of Thoracic and Cardiovascular Surgery 2005;130(1):20-8. - PubMed
NCT00839241 {published data only}
    1. NCT00839241. A clinical study to investigate if transfusion of patients own shed blood improves the immunological status in comparison to transfusion of donor blood ("bank blood"). clinicaltrials.gov/ct2/show/NCT00839241 First posted: 9 February 2009 (retrospective).
NCT01251042 {published data only}
    1. NCT01251042. A prospective, randomized, controlled study on intra-operative autologous transfusion with the Sangvia® blood salvage system in spinal surgery. clinicaltrials.gov/ct2/show/NCT01251042 First posted: 1 December 2010 (retrospective).
Nemani 2019 {published data only}
    1. Nemani VM, Kim HJ, Mina CA, Sheha ED, Ross T, Boachie-Adjei O. Postoperative blood salvage and autotransfusion for adult spinal deformity: a randomized controlled trial. Spine 2020;45(18):1247-52. [DOI: 10.1097/BRS.0000000000003176] - DOI - PubMed
Newman 1997 {published data only}
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Niranjan 2006 {published data only}
    1. Niranjan G, Asimakopoulos G, Karagounis A, Cockerill G, Thompson M, Chandrasekaran V. Effects of cell saver autologous blood transfusion on blood loss and homologous blood transfusion requirements in patients undergoing cardiac surgery on- versus off-cardiopulmonary bypass: a randomised trial. European Journal of Cardio-thoracic Surgery 2006;30(2):271-7. - PubMed
Page 1989 {published data only}
    1. Page R, Russell GN, Fox MA, Fabri BM, Lewis I, Williets T. Hard-shell cardiotomy reservoir for reinfusion of shed mediastinal blood. Annals of Thoracic Surgery 1989;48(4):514-7. - PubMed
Parrot 1991 {published data only}
    1. Parrot D, Lancon JP, Merle JP, Rerolle A, Bernard A, Obadia JF, et al. Blood salvage in cardiac surgery. Journal of Cardiothoracic and Vascular Anesthesia 1991;5(5):454-6. - PubMed
Pavelescu 2014 {published data only}
    1. Pavelescu D, Mirea L, Grintescu I. Combined perioperative use of tranexamic acid with a postoperative reinfusion/autotransfusion drainage system dramatically decrease the allogenic transfusion needs in total knee arthroplasty (TKA). European Journal of Anaesthesiology 2014;52:103-4 (Abstract 6AP5-4).
Pleym 2005 {published data only}
    1. Pleym H, Tjomsland O, Asberg A, Lydersen S, Wahba A, Bjella L, et al. Effects of autotransfusion of mediastinal shed blood on biochemical markers of myocardial damage in coronary surgery. Acta Anaesthesiologica Scandinavica 2005;49(9):1248-54. - PubMed
Reyes 2011 {published data only}
    1. Reyes G, Prieto MA, Alvarez P, Orts M, Bustamante J, Santos G, et al. Cell saving systems do not reduce the need of transfusion in low-risk patients undergoing cardiac surgery. Interactive Cardiovascular and Thoracic Surgery 2011;12(2):189-93. [DOI: 10.1510/icvts.2010.251538] - DOI - PubMed
Riou 1994 {published data only}
    1. Riou B, Arock M, Guerrero M, Ramos M, Thoreux P, Guillosson JJ, et al. Haematological effects of postoperative autotransfusion in spinal surgery. Acta Anaesthesiologica Scandinavica 1994;38(4):336-41. - PubMed
Rollo 1995 {published data only}
    1. Rollo VJ, Hozack WJ, Rothman RH, Chao W, Eng KO. Prospective randomized evaluation of blood salvage techniques for primary total hip arthroplasty. Journal of Arthroplasty 1995;10(4):532-9. - PubMed
Rosencher 1994 {published data only}
    1. Rosencher N, Vassilieff V, Tallet F, Toulon P, Leoni J, Tomeno B, et al. Comparison of Orth-Evac and Solcotrans Plus devices for the autotransfusion of blood drained after total knee joint arthroplasty. Annales Françaises d'Anesthésie et de Réanimation 1994;13(3):318-25. - PubMed
Sait 1999 {published data only}
    1. Sait MS, Earnshaw P. Autotransfusion in total knee arthroplasty. Is it worth the effort? Journal of Bone and Joint Surgery. British Volume 1999;81 (Suppl 2):244.
Šarkanoviü 2013 {published data only}
    1. Šarkanoviü ML, Gvozdenoviü L, Saviü D, Iliü MP, Jovanoviü G. Autologous blood transfusion in total knee replacement surgery. Vojnosanitetski Pregled 2013;70(3):274-8. [DOI: 10.2298/VSP1303274L] - DOI - PubMed
Savvidou 2009 {published data only}
    1. Savvidou C, Chatziioannou SN, Pilichou A, Pneumaticos SG. Efficacy and cost-effectiveness of cell saving blood autotransfusion in adult lumbar fusion. Transfusion Medicine 2009;19(4):202-6. [DOI: 10.1111/j.1365-3148.2009.00929.x] - DOI - PubMed
Schaff 1978 {published data only}
    1. Schaff HV, Hauer JM, Bell WR, Gardner TJ, Donahoo JS, Gott VL, et al. Autotransfusion of shed mediastinal blood after cardiac surgery. A prospective study. Journal of Thoracic and Cardiovascular Surgery 1978;75(4):632-41. - PubMed
    1. Schaff HV, Hauer JM, Brawley RK. Autotransfusion in cardiac surgical patients after operation. Surgery 1978;84(5):713-8. - PubMed
Schmidt 1996 {published data only}
    1. Schmidt H, Følsgaard S, Mortensen PE, Jensen E. Cardiac enzymes and autotransfusion of shed mediastinal blood after myocardial revascularization. Annals of Thoracic Surgery 1997;63:1288-92. - PubMed
    1. Schmidt H, Følsgaard S, Mortensen PE, Jensen E. Impact of autotransfusion after coronary artery bypass grafting on oxygen transport. Acta Anaesthesiologica Scandinavica 1997;41(8):995-1001. - PubMed
    1. Schmidt H, Mortensen PE, Følsgaard SL, Jensen EA. Autotransfusion after coronary artery bypass grafting halves the number of patients needing blood transfusion. Annals of Thoracic Surgery 1996;61(4):1177-81. [DOI: 10.1016/0003-4975(96)00002-1.] - DOI - PubMed
Schnurr 2018 {published data only}
    1. Schnurr C, Giannakopoulos I, Arbab D, Dargel J, Beckmann J, Eyse P. No benefit of autologous transfusion drains in total knee arthroplasty. Knee Surgery Sports Traumatology and Arthroscopy 2018;26(5):1557-63. [DOI: 10.1007/s00167-017-4585-8] - DOI - PubMed
Schönberger 1993 {published data only}
    1. Schönberger JP, Bredée J, Speekenbrink RG, Everts PA, Wildevuur ChR. Autotransfusion of shed blood contributes additionally to blood saving in patients receiving aprotinin (2 million KIU). European Journal of Cardio-thoracic Surgery 1993;7(9):474-7. - PubMed
Scrascia 2012 {published data only}
    1. Scrascia G, Rotunno C, Nanna D, Rociola R, Guida P, Rubino G, et al. Pump blood processing, salvage and re-transfusion improves hemoglobin levels after coronary artery bypass grafting, but affects coagulative and fibrinolytic systems. Perfusion 2012;27(4):270-7. [DOI: 10.1177/0267659112442236] - DOI - PubMed
Shen 2016 {published data only}
    1. ChiCTR-TRC-13003268. Application of autologous blood reinfusion in open-heart surgery with extracorporeal circulation at high risk of blood transfusion. www.chictr.org.cn/showproj.aspx?proj=6291 Date of registration: 09 June 2013 (prospective).
    1. Shen S, Zhang J, Wang W, Zheng J, Xie Y. Impact of intra-operative cell salvage on blood coagulation in high-bleeding-risk patients undergoing cardiac surgery with cardiopulmonary bypass: a prospective randomized and controlled trial. Journal of Translational Medicine 2016;14(1):228. [DOI: 10.1186/s12967-016-0986-6] - DOI - PMC - PubMed
Shenolikar 1997 {published data only}
    1. Shenolikar A, Wareham K, Newington D, Thomas D, Hughes J, Downes M. Cell salvage auto transfusion in total knee replacement surgery. Transfusion Medicine 1997;7(4):277-80. - PubMed
Shirvani 1991 {published data only}
    1. Shirvani R. An evaluation of clinical aspects of post-operative autotransfusion, either alone or in conjunction with pre-operative aspirin, in cardiac surgery. British Journal of Clinical Practice 1991;45(2):105-8. - PubMed
Smith 2007 {published data only}
    1. Smith LK, Williams DH, Langkamer VG. Post-operative blood salvage with autologous retransfusion in primary total hip replacement. The Journal of Bone and Joint Surgery. British Volume 2007;89(8):1092-7. - PubMed
    1. Williams D, Smith L, Langkamer VG. A randomised prospective study of post operative blood salvage with autologous retransfusion in primary total hip replacement. In: The Journal of Bone and Joint Surgery. British Volume (Proceedings). Vol. 91-B Suppl 1. 2009:102-10d. - PubMed
So‐Osman 2006 {published data only}
    1. So-Osman C, Nelissen RG, Eikenboom HC, Brand A. Efficacy, safety and user-friendliness of two devices for postoperative autologous shed red blood cell re-infusion in elective orthopaedic surgery patients: a randomized pilot study. Transfusion Medicine 2006;16(5):321-8. - PubMed
So‐Osman 2014 {published data only}
    1. ISRCTN96327523. Optimal blood management in elective orthopaedic surgery: the Transfusion "Op Maat" (TOMaat) study. www.isrctn.com/ISRCTN96327523 Submission date: 20 December 2005. Registration date: 20 December 2005 (retrospective).
    1. NCT00998088. Blood management in orthopedic surgery (TOMaat). clinicaltrials.gov/ct2/show/NCT00998088 First posted: 20 October 2009 (retrospective).
    1. NTR303. Optimal blood management in elective orthopaedic surgery. The Transfusion "Op Maat" (TOMaat) study. trialregister.nl/trial/265 Date of registration: 12/09/2005 (retrospective).
    1. So-Osman C, Balradj J, Koopman-van Gemert AWMM, Onstenk R, Van Den Hout WB, Brand R, et al. Patient blood management in elective orthopaedic hip-and knee replacement surgery-a report on clinical outcome. Vox Sanguinis 2016;111 (Suppl 1):282. [DOI: 10.1111/vox.12429] - DOI
    1. So-Osman C, Nelissen RG, Koopman-van Gemert AM, Kluyver E, Pöll R, Onstenk R, et al. A randomised controlled trial on erythropoietin and blood salvage as transfusion alternatives in orthopaedic surgery using a restrictive transfusion policy. Transfusion Alternatives in Transfusion Medicine 2011;12 (1):25-6. [DOI: 10.1111/j.1778-428X.2011.01149.x] - DOI
Spark 1997 {published data only}
    1. Farrer A, Spark JI, Scott DJ. Autologous blood transfusion: the benefits to the patient undergoing abdominal aortic aneurysm repair. Journal of Vascular Nursing 1997;15(4):111-5. - PubMed
    1. Spark JI, Chetter IC, Kester RC, Scott DJ. Allogeneic versus autologous blood during abdominal aortic aneurysm surgery. European Journal of Vascular and Endovascular Surgery 1997;14(6):482-6. - PubMed
Springer 2016 {published data only}
    1. NCT01636414. Reinfusion drains vs tranexamic acid in total joint arthroplasty. clinicaltrials.gov/ct2/show/NCT01636414 First posted: 10 July 2012 (retrospective).
    1. Springer BD, Odum SM, Fehring TK. What is the benefit of tranexamic acid vs reinfusion drains in total joint arthroplasty? Journal of Arthroplasty 2016;31(1):76-80. [DOI: 10.1016/j.arth.2015.08.006] - DOI - PubMed
Teetzman 2014 {published data only}
    1. NCT01725724. Effects of the Sangvia blood collection system on postoperative infections in orthopedic patients. clinicaltrials.gov/ct2/show/NCT01725724 First posted: 14 November 2012 (retrospective).
    1. Teetzmann R, Sørensen B, Liseth K, Opheim E, Hervig T. Effects of the Sangvia blood collection system on patients undergoing elective hip surgery. Transfusion and Apheresis Science 2014;51(2):91-6. [DOI: 10.1016/j.transci.2014.08.004] - DOI - PubMed
Thomas 2001 {published data only}
    1. Thomas D, Wareham K, Cohen D, Hutchings H. Autologous blood transfusion in total knee replacement surgery. British Journal of Anaesthesia 2001;86(5):669-73. [DOI: 10.1093/bja/86.5.669] [PMID: ] - DOI - PubMed
Thomassen 2011 {published data only}
    1. NCT00822588. Comparison in need for bank blood between patients undergoing total hip surgery that either receive their own blood back or not. clinicaltrials.gov/ct2/show/NCT00822588 First posted: 14 January 2009 (prospective).
    1. Thomassen BJ, Pilot P, Grohs J, Holen K, Bisbe E, Poolman RW. A prospective, randomized, controlled trial of retransfusion of intra-operatively collected filtered whole blood in total hip surgery with the sangvia blood reinfusion system. Vox Sanguinis 2011;1:191.
Thomassen 2014 {published data only}
    1. NTR2501. The effect of duration of wound drainage on allogeneic blood transfusions using a postoperative retransfusion system after major orthopaedic surgery. trialsearch.who.int/Trial2.aspx?TrialID=NTR2501 Date of registration: 09 September 2010 (retrospective).
    1. Thomassen BJ, Pilot P, Scholtes VA, Grohs JG, Holen K, Bisbe E, Poolman RW. Limit allogeneic blood use with routine re-use of patient’s own blood: a prospective, randomized, controlled trial in total hip surgery. PLoS One 2012;7(9):E44503 (1-9). - PMC - PubMed
    1. Thomassen BJ, den Hollander PH, Kaptijn HH, Nelissen RG, Pilot P. Autologous wound drains have no effect on allogeneic blood transfusions in primary total hip and knee replacement: a three-arm randomised trial. Bone and Joint Journal 2014;96-B(6):765-71. [DOI: 10.1302/0301-620X.96B6.33021] - DOI - PubMed
Thompson 1990 {published data only}
    1. Thompson JF, Webster JH, Chant AD. Prospective randomised evaluation of a new cell saving device in elective aortic reconstruction. European Journal of Vascular Surgery 1990;4(5):507-12. - PubMed
Thurer 1979 {published data only}
    1. Thurer RL, Lytle BW, Cosgrove DM, Loop FD. Autotransfusion following cardiac operations: a randomized, prospective study. Annals of Thoracic Surgery 1979;27(6):500-7. - PubMed
Touzopoulos 2021 {published data only}
    1. NCT04505748. Is self-transfusion safe after total knee arthroplasty in terms of nephrotoxicity of gentamicin from bone cement? clinicaltrials.gov/ct2/show/NCT04505748 First posted: 10 August 2020 (retrospective).
    1. Touzopouos P, Arvanitidis K, Filidou E, Tikeridis K, Karanikas M, Kolios G, et al. Is serum gentamicin concentration modified with autologous cell-saved blood transfusion after total knee arthroplasty using tranexamic acid? A randomised control trial. Orthopaedics & Traumatology: Surgery & Research 2021;107(3):102794. [DOI: 10.1016/j.otsr.2020.102794] [PMID: ] - DOI - PubMed
Tripkovic 2008 {published data only}
    1. Tripkovic B, Bukovic D, Sakic K, Sakic S, Bukovic N, Radakovic B. Quality of the blood sampled from surgical drainage after total hip arthroplasty. Collegium Antropologicum 2008;32(1):153-60. - PubMed
Unsworth 1996 {published data only}
    1. Unsworth-White MJ, Kallis P, Cowan D, Tooze JA, Bevan DH, Treasure T. A prospective randomised controlled trial of postoperative autotransfusion with and without a heparin-bonded circuit. European Journal of Cardio-thoracic Surgery 1996;10(1):38-47. - PubMed
Vermeijden 2015 {published data only}
    1. De Vries AJ, Vermeijden WJ, Van Pelt LJ, Van den Heuvel ER, Van Oeveren W. Additional filtering of blood from a cell salvage device is not likely to show important additional benefits in outcome in cardiac surgery. Transfusion 2019;59(3):989-94. [DOI: 10.1111/trf.15130] [PMID: ] - DOI - PubMed
    1. ISRCTN58333401. The clinical effects of leukocyte removal filters, cell savers and their combination on blood transfusion and organ damage during cardiac surgery. www.isrctn.com/ISRCTN58333401 Submission date: 20 December 2005. Registration date: 20 December 2005 (retrospective). [DOI: 10.1186/ISRCTN58333401] - DOI
    1. NTR244. The clinical effects of leukocyte removal filters, cellsavers and their combination on blood transfusion and organ damage during cardiac surgery. trialregister.nl/trial/207 Date of registration: 07 September 2005 (retrospective).
    1. Van Klarenbosch J, Van den Heuvel ER, Van Oeveren W, De Vries AJ. Does intraoperative cell salvage reduce postoperative infection rates in cardiac surgery? Journal of Cardiothoracic and Vascular Anesthesia 2020;34:1457-63. [DOI: 10.1053/j.jvca.2020.01.023] - DOI - PubMed
    1. Vermeijden WJ, Van Klarenbosch J, Gu YJ, Mariani MA, Buhre WF, Scheeren TWL, et al. Effects of cell-saving devices and filters on transfusion in cardiac surgery: a multicenter randomized study. Annals of Thoracic Surgery 2015;99(1):26-32. [DOI: 10.1016/j.athoracsur.2014.08.027] - DOI - PubMed
Ward 1993 {published data only}
    1. Ward HB, Smith RR, Landis KP, Nemzek TG, Dalmasso AP, Swaim WR. Prospective, randomized trial of autotransfusion after routine cardiac operations. Annals of Thoracic Surgery 1993;56(1):137-41. - PubMed
Westerberg 2004 {published data only}
    1. Westerberg M, Bengtsson A, Jeppsson A. Coronary surgery without cardiotomy suction and autotransfusion reduces the postoperative systemic inflammatory response. Annals of Thoracic Surgery 2004;78(1):54-9. - PubMed
Xie 2015 {published data only}
    1. ChiCTR-TRC-13003209. Efficacy and safety of intraoperative Cell Saver in cardiac surgery associated with cardiopulmonary bypass circuit. www.chictr.org.cn/showprojen.aspx?proj=6350 Date of registration: 05 May 2013 (prospective).
    1. Xie Y, Shen S, Zhang J, Wang W, Zheng J. The efficacy, safety and cost-effectiveness of intra-operative cell salvage in high-bleeding-risk cardiac surgery with cardiopulmonary bypass: a prospective randomized and controlled trial. International Journal of Medical Sciences 2015;12(4):322-8. [DOI: 10.7150/ijms.11227] - DOI - PMC - PubMed
Zhang 2008 {published data only}
    1. Zhang XF, Dong JM, Gong ML, Shen SM, Zhou Y, Pan YF, Mao J. Effectiveness of preoperative autologous plateletpheresis combined with intraoperative autotransfusion on the blood coagulation in orthopaedic patients. Chung-Hua Wai Ko Tsa Chih [Chinese Journal of Surgery] 2008;46(2):118-21. - PubMed
Zhao 1996 {published data only}
    1. Zhao K, Xiao M, Deng S. Autotransfusion of shed medistinal blood after open heart operation. Chinese Journal of Surgery 1996;34(8):497-9. - PubMed
Zhao 2003 {published data only}
    1. Zhao K, Xu J, Hu S, Wu Q, Wei Y, Liu Y. Autotransfusion of shed mediastinal blood after open heart surgery. Chinese Medical Journal 2003;116:1179-82. - PubMed
Zhao 2016 {published data only}
    1. Zhao JT, Jiang Z, Chen JF, Cao XD, Luo Y, Shen WZ. Safety and effectiveness of autologous blood transfusion after total hip arthroplasty. Chinese Journal of Tissue Engineering Research 2016;20(4):465-9. [URL: www.cjter.com/EN/abstract/abstract11187.shtml]
Zhao 2017 {published data only}
    1. Zhao H, Ma H, Meng L, Zhao Z, Quan X, Cheng Z. Application of autologous blood cell salvage in off-pump coronary artery bypass graft operation. Heart Surgery Forum 2017;20(3):E107-110. [DOI: 10.1532/hsf.1609] - DOI - PubMed

References to studies excluded from this review

Albano 2010 {published data only}
    1. Albano G, Inghilleri G, Parinello M, Roscitano C, Borromeo U. Efficacy and safety in post-operative autologous blood reinfusion. Transfusion Medicine 2010;1:49 (Abstract no. PO54). [DOI: 10.1111/j.1365-3148.2010.01029.x] - DOI
Barbara 2010 {published data only}
    1. Barbara E, Di Spigno N, Perazzo P, Scardino M. A new concept in the post-operative autologous blood reinfusion in orthopaedic surgery. Regional Anesthesia and Pain Medicine 2010;35(5):E67 (Abstract no. 122). [DOI: 10.1097/AAP.0b013e3181f3582c] - DOI
Bartels 1996 {published data only}
    1. Bartels C, Bechtel JV, Winkler C, Horsch S. Intraoperative autotransfusion in aortic surgery: comparison of whole blood autotransfusion versus cell separation. Journal of Vascular Surgery 1996;24(1):102-8. [DOI: ] - PubMed
Bisleri 2016 {published data only}
    1. Bisleri G, Tononi L, Morgan JA, Bordonali T, Cheema FH, Siddiqui OT, et al. Separation of mediastinal shed blood during aortic valve surgery elicits a reduced inflammatory response. Journal of Cardiovascular Medicine 2016;17(1):62-8. [DOI: ] - PubMed
Bosboom 2022 {published data only}
    1. Bosboom JJ, Klanderman RB, Terwindt LE, Bulle EB, Wijnberge M, Eberl S, et al. Autologous red blood cell transfusion does not result in a more profound increase in pulmonary capillary wedge pressure compared to saline in critically ill patients: a randomized crossover trial. Vox Sanguinis 2022;117(8):1035-42. [DOI: ] - PMC - PubMed
    1. NCT03135457. TACO crossover trial. clinicaltrials.gov/ct2/show/study/NCT03135457 First posted: 1 May 2017 (prospective).
Boyle 2019 {published data only}
    1. Boyle G, Kuffel A, Parmar K, Gibson K, Smith M, Grehan A, et al. A comparison of haemostatic biomarkers during low-risk patients undergoing cardiopulmonary bypass using either conventional centrifugal cell salvage or the HemoSep device. Perfusion 2019;34(1):76-83. [DOI: ] - PubMed
Campbell 2012b {published data only}
    1. Campbell J, Holland C, Richens D, Skinner H. Impact of cell salvage during cardiac surgery on the thrombelastomeric coagulation profile: a pilot study. Perfusion 2012;27(3):221-4. [DOI: ] - PubMed
Chen 2020 {published data only}
    1. Chen H, Tan H, Luo PX, Shen YF, Lyu CC, Qian XW, et al. Comparison of cell salvage with one and two suction devices during cesarean section in patients with placenta previa and/or accrete: a randomized controlled trial. Chinese Medical Journal 2020;133(6):638-43. [DOI: ] [URL: https://journals.lww.com/cmj/Fulltext/2020/03200/Comparison_of_cell_salv...] - PMC - PubMed
Cheng 2014 {published data only}
    1. Cheng W, Xu H, Xiao Z, Ren Y, Zheng Q, Kan W. Effect of autologous drained blood reinfusion on hidden blood loss and limb swelling following rivaroxaban anticoagulation for primary total hip arthroplasty. Nan Fang Yi Ke Da Xue Xue Bao [Journal of Southern Medical University] 2014;34(3):438-40. [DOI: 10.3969/j.issn.1673-4254.2014.03.32] - DOI - PubMed
ChiCTR1800016656 {published data only}
    1. ChiCTR1800016656. The application study of apheresis autologous red blood cell on spinal surgery. www.chictr.org.cn/showproj.aspx?proj=28050 Date of registration: 14 June 2018 (prospective).
ChiCTR1800018689 {published data only}
    1. ChiCTR1800018689. Clinical study for intraoperative cell salvage in Caesarean section. www.chictr.org.cn/com/25/showproj.aspx?proj=31610 Date of registration: 03 October 2018 (retrospective).
ChiCTR‐OCC‐15006016 {published data only}
    1. ChiCTR-OCC-15006016. Comparison of prognosis between intraoperative cell salvage and allogeneic transfusion for operation patients. www.chictr.org.cn/showproj.aspx?proj=10482 Date of registration: 29 October 2014 (prospective).
ChiCTR‐ORN‐17013372 {published data only}
    1. ChiCTR-ORN-17013372. Intraoperative cell salvage during caesarean section for placenta accreta. www.chictr.org.cn/showproj.aspx?proj=22899 Date of registration: 14 November 2017 (retrospective).
Choi 2019 {published data only}
    1. Choi HY, Hyun SJ, Kim KJ, Jahng TA, Kim HJ. Clinical efficacy of intra-operative cell salvage system in major spinal deformity surgery. Journal of Korean Neurosurgical Society 2019;62(1):53-60. [DOI: 10.3340/jkns.2017.0287] - DOI - PMC - PubMed
Conn 2018 {published data only}
    1. Conn C, Johnson PM, Van Buskirk C, Santrach P. Utilizing box plots to monitor and investigate quality control results for multiple blood salvage devices. Transfusion 2018;58:157A-157A (abstract no. QT9).
Deramoudt 1991 {published data only}
    1. Deramoudt V, Menestret P, Melledant Y, Chartier M, Sellin M, Le Couls H, et al. Autologous transfusion in cardiac surgery [Transfusion autologue en chirurgie cardiaque (à propos de 74 patients)]. Cahiers d'Anesthésiologie 1991;39(3):153-9. - PubMed
Dickenson 2022 (WHITE‐9) {published data only}
    1. Dickenson E, Griffin XL, Achten J, Mironov K, O'Connor H, Parsons N, et al. Randomised controlled trial comparing intraoperative cell salvage and autotransfusion with standard care in the treatment of hip fractures: a protocol for the WHITE 9 study. BMJ Open 2022;12(6):e062338. [DOI: 10.1136/bmjopen-2022-062338] - DOI - PMC - PubMed
    1. ISRCTN15945622. A multi centre randomised controlled trial comparing intra operative cell salvage with standard care in the treatment of hip fractures. www.isrctn.com/ISRCTN15945622 Submission date: 27 August 2019; registration date: 10 September 2019 (prospective). [DOI: 10.1186/ISRCTN15945622] - DOI
Djaiani 2012 (NCT00296985) {published data only}
    1. Djaiani G, Fedorko L, Borger MA, Green R, Carroll J, Marcon M, et al. Continuous-flow cell saver reduces cognitive decline in elderly patients after coronary bypass surgery. Circulation 2007;116(17):1888-95. [DOI: 10.1161/CIRCULATIONAHA.107.698001] [PMID: ] - DOI - PubMed
    1. Djaiani G, Katznelson R, Fedorko L, Rao V, Green R, Carroll J, et al. Early benefit of preserved cognitive function is not sustained at one-year after cardiac surgery: a longitudinal follow-up of the randomized controlled trial. Canadian Journal of Anaesthesia 2012;59(5):449-55. [DOI: 10.1007/s12630-012-9675-y] - DOI - PubMed
    1. NCT00296985. Continuous cellsaver and neurocognitive decline post cardiac surgery. clinicaltrials.gov/ct2/show/study/NCT00296985 First posted: 27 February 2006 (retrospective).
DRKS00025454 {published data only}
    1. DRKS00025454. Comparative study of vacuum drainage associated hemolysis during cell salvage of cardiotomy suction blood [Vergleichende Untersuchung der vakuumbedingten Hämolyse bei der Evakuation von Kardiotomieblut]. drks.de/search/de/trial/DRKS00025454 Date of registration in DRKS: 06 January 2021 (prospective).
Duramaz 2018 {published data only}
    1. Duramaz A, Bilgili MG, Bayram B, Ziroğlu N, Edipoğlu E, Öneş HN, et al. The role of intraoperative cell salvage system on blood management in major orthopedic surgeries: a cost-benefit analysis. European Journal of Orthopaedic Surgery & Traumatology 2018;28(5):991-7. [DOI: 10.1007/s00590-017-2098-2] - DOI - PubMed
Ela 2009 {published data only}
    1. Ela Y, Emmiler M, Kocogullari CU, Terzi Y, Sivaci RG, Cekirdekci A. Advantages of autologous blood transfusion in off-pump coronary artery bypass. Heart Surgery Forum 2009;12(5):E261-5. [DOI: ] - PubMed
Elawad 1992 {published data only}
    1. Elawad AA, Ohlin AK, Berntorp E, Nilsson IM, Fredin H. Autologous blood transfusion in revision hip arthroplasty. A prospective, controlled study of 30 patients. Acta Orthopaedica Scandinavica 1992;63(4):373-6. - PubMed
Gäbel 2013b {published data only}
    1. Gäbel J, Westerberg M, Bengtsson A, Jeppsson A. Cell salvage of cardiotomy suction blood improves the balance between pro- and anti-inflammatory cytokines after cardiac surgery. European Journal of Cardio-Thoracic Surgery 2013;44(3):506-11. [DOI: ] - PubMed
Garg 2015 {published data only}
    1. Garg P, Malhotra A, Desai M, Sharma P, Bishnoi AK, Tripathi P et al. Pretransfusion comparison of dialyser-based hemoconcentrator with cell saver system for perioperative cell salvage. Innovations: Technology & Techniques in Cardiothoracic & Vascular Surgery 2015;10(5):334-41. [DOI: ] - PubMed
Gorki 2017 (HEPCON II) {published data only}
    1. DRKS00008832. Influence of fluid balance and recirculation of pericardial fluids during coronary artery bypass grafting on protamine dosing and on markers of coagulation. drks.de/search/en/trial/DRKS00008832 Date of registration in DRKS: 24 June 2015 (prospective).
    1. Gorki H, Nakamura J, Kunert A, Hoenicka M, Liebold A. Pericardial fluids or cardiopulmonary bypass: Is there a major culprit for changes in coagulation and inflammation? In: Thoracic and Cardiovascular Surgeon. Conference: 46th Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery, DGTHG. Vol. 65 (Supp 1). 2017:S1-S110. [DOI: 10.1055/s-0037-1598913] - DOI - PubMed
    1. Gorki H, Nakamura J, Kunert A, Hoenicka M, Liebold A. Pericardial fluids or cardiopulmonary bypass: Is there a major culprit for changes in coagulation and inflammation? Thoracic and Cardiovascular Surgeon 2020;68:219-22. [DOI: ] - PubMed
Gu 2009 {published data only}
    1. Gu YJ, Vries AJ, Hagenaars JA, Oeveren W. Leucocyte filtration of salvaged blood during cardiac surgery: effect on red blood cell function in concentrated blood compared with diluted blood. European Journal of Cardio-Thoracic Surgery 2009;36(5):877-82. [DOI: ] - PubMed
Gunaydin 2013 {published data only}
    1. Gunaydin S, Gourlay T. Novel ultrafiltration technique for blood conservation in cardiac operations. Annals of Thoracic Surgery 2013;95(6):2148-51. [DOI: ] - PubMed
Gunaydin 2018 {published data only}
    1. Gunaydin S, Robertson C, Budak AB, Gourlay T. Comparative evaluation of blood salvage techniques in patients undergoing cardiac surgery with cardiopulmonary bypass. Perfusion 2018;33(2):105-9. [DOI: ] - PubMed
Han 2021 {published data only}
    1. Han Z, Wang M, Yu S. Effects of stored autotransfusion on electrolytes and postoperative complications in patients undergoing elective orthopedic surgery. American Journal of Translational Research 2021;13(6):7200-6. [PMID: ] - PMC - PubMed
Harlaar 2012 {published data only}
    1. Busch O, Hop W, Pependrecht MH, Marquet RL, Jeekel J. Blood transfusions and prognosis in colorectal cancer. New England Journal of Medicine 1993;328:1372-6. [DOI: 10.1056/NEJM199305133281902] - DOI - PubMed
    1. Harlaar JJ, Gosselink MP, Hop WC, Lange JF, Busch OR, Jeekel H. Blood transfusions and prognosis in colorectal cancer: long-term results of a randomized controlled trial. Annals of Surgery 2012;256(5):681‐7. [DOI: ] - PubMed
Hasan 2017 {published data only}
    1. Hasan MS, Choe NC, Chan CYW, Chiu CK, Kwan MK. Effect of intraoperative autologous transfusion techniques on perioperative hemoglobin level in idiopathic scoliosis patients undergoing posterior spinal fusion: A prospective randomized trial. Journal of Orthopaedic Surgery 2017;25(2):2309499017718951. [DOI: ] - PubMed
    1. NCT02112409. Intraoperative cell salvage and hemodilution technique in scoliosis surgery. clinicaltrials.gov/ct2/show/study/NCT02112409 First posted: 14 April 2014 (retrospective).
Hogan 2014 {published data only}
    1. Hogan M, Needham A, Ortmann E, Bottrill F, Besser M, Klein A. A randomized controlled trial of the effect of concentrating residual cardiopulmonary bypass blood using Hemosep on patient haematocrit after cardiac surgery. Applied Cardiopulmonary Pathophysiology 2014;18 (Suppl):51-2 (Abstract no. O-49).
Hogan 2015 {published data only}
    1. Hogan M, Needham A, Ortmann E, Bottrill F, Collier TJ, Besser MW, et al. Haemoconcentration of residual cardiopulmonary bypass blood using Hemosep: a randomised controlled trial. Anaesthesia 2015;70(5):563-70. [DOI: ] - PubMed
ISRCTN59539154 (MASS III) {published data only}
    1. ISRCTN59539154. Off-pump vs on-pump surgery in patients with stable coronary artery disease. https://www.isrctn.com/ISRCTN59539154 Submission date 21/02/2008; registration date 10/03/2008 (retrospective). [DOI: ]
    1. Vieira de Melo RM, Hueb W, Rezende PC, Alves da Costa LM, Oikawa FT, Lima EG, et al. Comparison between off-pump and on-pump coronary artery bypass grafting in patients with severe lesions at the circumflex artery territory: 5-year follow-up of the MASS III trial. European Journal of Cardiothoracic Surgery 2015;47(3):455-8. [DOI: 10.1093/ejcts/ezu216] [PMID: ] - DOI - PubMed
    1. Vieira de Melo RM, Hueb W, Rezende PC, Lima EG, Hueb AC, Ramires JA, et al. On-pump versus off-pump coronary artery bypass surgery in patients older than 60 years: five-year follow-up of MASS III trial. Journal of Cardiothoracic Surgery 2014;9:127. [DOI: 10.1186/1749-8090-9-136] [PMID: ] - DOI - PMC - PubMed
ISRCTN85756518 {published data only}
    1. ISRCTN85756518. Autologous transfusion in surgery: a randomised clinical trial. www.isrctn.com/ISRCTN85756518 Submission date: 23 January 2004; registration date: 23 January 2004 (retrospective). [DOI: 10.1186/ISRCTN85756518] - DOI
ISRCTN87590585 {published data only}
    1. Boodhwani M, Nathan HJ, Mesana TG, Rubens FD, on behalf of Cardiotomy Investigators. Effects of shed mediastinal blood on cardiovascular and pulmonary function: a randomized, double-blind study. Annals of Thoracic Surgery 2008;86(4):1167-73. [DOI: 10.1016/j.athoracsur.2008.06.029] [PMID: ] - DOI - PubMed
    1. ISRCTN87590585. Clinical relevance of cardiotomy blood salvage during cardiopulmonary bypass. www.isrctn.com/ISRCTN87590585 Submission date: 26 September 2005; registration date 26 September 2005 (retrospective). [DOI: 10.1186/ISRCTN87590585] - DOI
    1. Rubens FD, Boodhwani M, Mesana T, Wozny D, Wells G, Nathan HJ, Cardiotomy Investigators. The cardiotomy trial: a randomized, double-blind study to assess the effect of processing of shed blood during cardiopulmonary bypass on transfusion and neurocognitive function. Circulation 2007;116(11 (Suppl)):i89-97. [DOI: 10.1161/CIRCULATIONAHA.106.678987] [PMID: ] - DOI - PubMed
Jenni 2011 {published data only}
    1. Jenni H, Rheinberger J, Czerny M, Gygax E, Rieben R, Krahenbuhl E, et al. Autotransfusion system or integrated automatic suction device in minimized extracorporeal circulation: influence on coagulation and inflammatory response. European Journal of Cardio-Thoracic Surgery 2011;39(5):e139-43. [DOI: ] - PubMed
JPRN UMIN 000019726 {published data only}
    1. UMIN000019726. Coagulation and fibrinolytic function in use of intraoperative blood salvage for cardiovascular surgery. center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000022782 Registered date: 10 November 2015 (prospective).
JPRN UMIN 000022227 {published data only}
    1. UMIN000022227. Differences in biological responses between open and closed system cardiopulmonary bypass for adult cardiac surgery. center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000022145 Registered date: 6 May 2016 (retrospective).
JPRN UMIN 000025157 {published data only}
    1. UMIN000025157. Coagulation and fibrinolytic function in use of intraoperative blood salvage for cardiovascular surgery/comparative test with other infusion. center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000028939 Registered date: 6 December 2016 (prospective).
JPRN UMIN 000043920 {published data only}
    1. JPRN-UMIN000043920. Efficacy of cell saver system during cesarean section. center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047046 Date of disclosure of the study information: 15 April 2021 (retrospective).
Karlsson 2019 {published data only}
    1. Karlsson M, Hannuksela M, Appelblad M, Hallgren O, Johagen D, Wahba A, et al. Cardiopulmonary bypass and dual antiplatelet therapy: a strategy to minimise transfusions and blood loss. Perfusion 2019;35(3):236-45. [DOI: ] - PubMed
Khan 2022 {published data only}
    1. Khan MI, Ashraf M, Iqbal H. Normovolumetric haemodilution and auto transfusion in major operations prevents transfusion-related complications. Bangladesh Journal of Medical Science 2022;21(3):547-52. [DOI: ]
Khanuja 2023 {published data only}
    1. Khanuja K, Iyer N, Roman A, Al-Kouatly HB. Use of cell salvage at time of cesarean section: a systematic review and meta-analysis. American Journal of Obstetrics and Gynecology 2023;228 (Suppl 1):s509-s510. [DOI: 10.1016/j.ajog.2022.11.872] - DOI - PubMed
Laub 1993 {published data only}
    1. Laub GW, Dharan M, Riebman JB, Chen C, Moore R, Bailey BM, et al. The impact of intraoperative autotransfusion on cardiac surgery. A prospective randomized double-blind study. Chest 1993;104(3):686-9. - PubMed
Mayer 1985 {published data only}
    1. Mayer ED, Welsch M, Tanzeem A, Saggau W, Spath J, Hummels R, et al. Reduction of postoperative donor blood requirement by use of the cell separator. Scandinavian Journal of Thoracic Cardiovascular Surgery 1985;19(2):165-71. - PubMed
McGill 2002 {published data only}
    1. McGill N, O'Shaughnessy D, Pickering R, Herbertson M, Gill R. Mechanical methods of reducing blood transfusion in cardiac surgery: randomised controlled trial. BMJ 2002;324(7349):1299. Erratum in: BMJ 2002; 20;325(7356):142. - PMC - PubMed
McNair 2013 {published data only}
    1. McNair E, McKay W, Qureshi AM, Rosin M, Gamble J, Dalshaug G, et al. Outcomes and biochemical parameters following cardiac surgery: effects of transfusion of residual blood using centrifugation and multiple-pass hemoconcentration. Journal of Cardiothoracic & Vascular Anesthesia 2013;27(6):1174-80. [DOI: ] - PubMed
    1. NCT01416792. Centrifugation vs. multiple-pass hemofiltration of the residual cardiopulmonary bypass volume. clinicaltrials.gov/ct2/show/study/NCT01416792 First posted: 15 August 2011 (retrospective).
McNair 2020 {published data only}
    1. McNair ED, McKay WP, Mondal PK, Bryce RDT. Transfusion use and hemoglobin levels by blood conservation method after cardiopulmonary bypass. Annals of Thoracic Surgery 2020;110(5):1520-26. [DOI: ] - PubMed
Morisaki 2013 {published data only}
    1. Morisaki A, Nakahira A, Sasaki Y, Hirai H, Okada Y, Suehiro S, et al. Is elimination of cardiotomy suction preferable in aortic valve replacement? Assessment of perioperative coagulation, fibrinolysis and inflammation. Interactive Cardiovascular and Thoracic Surgery 2013;17(3):507-14. [DOI: ] - PMC - PubMed
Murtha‐Lemekhova 2022 {published data only}
    1. Murtha-Lemekhova A, Fuchs J, Ritscher E, Hoffmann K. Effect of autotransfusion in HCC surgery on survival and recurrence: a systematic review and meta-analysis. Cancers 2022;14(9):4837. [DOI: ] - PMC - PubMed
Naumenko 2003 {published data only}
    1. Naumenko SE, Pokrovskii MG, Belavin AS, Kim SF. Blood-saving effectiveness of preoperative reservation of autoblood for surgical treatment of ischaemic heart disease. Vestnik khirurgii imeni I. I. Grekova [Grekov's Bulletin of Surgery] 2003;162:59-64. - PubMed
NCT00176657 {published data only}
    1. NCT00176657. The use of HEMOBAG to salvage blood after cardiac surgery. clinicaltrials.gov/ct2/show/NCT00176657 First posted: 15 September 2005 (retrospective).
NCT01435304 {published data only}
    1. NCT01435304. The effect of the Hemobag® ultrafiltration system on blood conservation and coagulation after cardiopulmonary bypass. clinicaltrials.gov/ct2/show/study/NCT01435304 First posted: 16 September 2011 (prospective).
NCT02338947 {published data only}
    1. NCT02338947. Off-pump versus on-pump coronary artery bypass grafting in frail patients (FRAGILE). clinicaltrials.gov/ct2/show/NCT02338947 First posted: 15 January 2015 (prospective).
NCT02654028 {published data only}
    1. NCT02654028. Association between autologous transfusion and recurrence among patients with HCC after resection (AT/HCC). clinicaltrials.gov/ct2/show/study/NCT02654028 First posted: 13 January 2016 (prospective).
NCT03995160 {published data only}
    1. NCT03995160. Influence of closed suction drainage after total knee replacement. clinicaltrials.gov/ct2/show/NCT03995160 First posted: 21 June 2019 (prospective).
NCT04304287 {published data only}
    1. NCT04304287. The benefit of autologous blood transfusion in total hip arthroplasty. clinicaltrials.gov/ct2/show/NCT04304287 First posted: 11 March 2020 (retrospective).
NCT04588350 {published data only}
    1. NCT04588350. Clinical investigation evaluating a new autotransfusion device in cardiac surgery (i-TRANSEP). clinicaltrials.gov/ct2/show/NCT04588350 First posted: 19 October 2020 (retrospective).
NCT05164406 {published data only}
    1. NCT05164406. Impact of blood salvage therapy during oncologic liver surgeries on allogenic transfusion events, survival and recurrence. clinicaltrials.gov/ct2/show/NCT05164406 First posted: 20 December 2021 (retrospective).
NCT05401175 {published data only}
    1. NCT05401175. Application of stored autologous blood transfusion therapy for bone marrow protection. clinicaltrials.gov/ct2/show/NCT05401175 First posted: 2 June 2022 (retrospective).
NCT05545930 {published data only}
    1. NCT05545930. Analysis of red blood cell integrity and efficiency of recovery using a novel surgical sponge-blood recovery device (ProCell): immediate impact. clinicaltrials.gov/ct2/show/NCT05545930 First posted: 19 September 2022 (prospective).
NTR1589 {published data only}
    1. NTR1589. Does have autologous bloodwithdrawal with or without sequestration effect on the usage of allogeneic blood products during heartsurgery? trialsearch.who.int/Trial2.aspx?TrialID=NTR1589 Date of registration: 15 December 2008 (prospective).
NTR2712 {published data only}
    1. NTR2712. Quality assessment of cell saved blood. trialsearch.who.int/Trial2.aspx?TrialID=NTR2712 Date of registration: 25 January 2011 (prospective). [URL: trialregister.nl/trial/2587]
Nunes 2019 {published data only}
    1. Nunes NG, Oliveira JAA, Bezerra FMP, Nascimento VDD, Dumaresq DMH, Patrocinio MCA. Is intraoperative blood cell salvage effective in hip surgery? Revista Brasileira de Ortopedia (Sao Paulo) 2019;54(4):377-81. [DOI: ] - PMC - PubMed
Quispe‐Fernández 2020 {published data only}
    1. Quispe-Fernández LA, Carrillo-González ML, Gutiérrez-Ospina A, Gómez Leandro II. Blood products with autologous transfusion versus allogeneic transfusion in cardiac surgery patients. Revista Medica del Instituto Mexicano del Seguro Social 2020;58(4):417-27. - PubMed
Santiago‐Lopez 2021 {published data only}
    1. Santiago-Lopez J, Leon-Ramirez V, Barragan-Zamora JA, Merino-Machuca YA. Effect of the use of operative blood salvage on the pulmonary gas exchange in patients undergoing cardiac surgery [Efecto del uso del recuperador celular en el intercambio gaseoso en pacientes sometidos a cirugía cardíaca]. Revista Mexicana de Anestesiologia 2021;44(3):173-7. [DOI: ]
Schmidt 1997 {published data only}
    1. Schmidt H, Lund JO, Nielsen SL. Autotransfused shed mediastinal blood has normal erythrocyte survival. Annals of Thoracic Surgery 1996;62(1):105-8. - PubMed
Sirvinskas 2007 {published data only}
    1. Sirvinskas E, Veikutiene A, Benetis R, Grybauskas P, Andrejaitiene J, Veikutis V, et al. Influence of early re-infusion of autologous shed mediastinal blood on clinical outcome after cardiac surgery. Perfusion 2007;22(5):345-52. - PubMed
Slagis 1991 {published data only}
    1. Slagis SV, Benjamin JB, Volz RG, Giordano GF. Postoperative blood salvage in total hip and knee arthroplasty. A randomised controlled trial. Journal of Bone and Joint Surgery. British Volume 1991;73(4):591-4. - PubMed
Soliman 2022 {published data only}
    1. Soliman R, Saad D, Abukhudair W, Abdeldayem S. The neurocognitive outcomes of hemodilution in adult patients undergoing coronary artery bypass grafting using cardiopulmonary bypass. Annals of Cardiac Anaesthesia 2022;25(2):133-40. [DOI: ] [PMID: ] - PMC - PubMed
Sridhar 2019 {published data only}
    1. Sridhar S, Abdelmonem M. Prospective study comparing usage of closed-suction drains in elective total hip replacement (THR) procedures at an NHS district general hospital. In: Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) 40th Orthopaedic World Congress. 2019.
Starlinger 2016 {published data only}
    1. Starlinger J, Schmidt R, Machold W. Post-operative retransfusion of unwashed filtered shed blood reduces allogenic blood demand in hip hemiarthroplasty in traumatic femoral neck fractures-a prospective randomized trial. International Orthopaedics 2016;40(12):2575-9. [DOI: ] [PMID: ] - PubMed
Tachias 2022 {published data only}
    1. Tachias F, Samara E, Petrou A, Karakosta A, Siminelakis S, Apostolakis E, et al. The effect of cell salvage on bleeding and transfusion needs in cardiac surgery. Anesthesiology Research and Practice 2022;2022:Article ID 3993452. [DOI: ] - PMC - PubMed
Tempe 1996 {published data only}
    1. Tempe D, Bajwa R, Cooper A, Nag B, Tomar AS, Khanna SK, et al. Blood conservation in small adults undergoing valve surgery. Journal of Cardiothoracic and Vascular Anesthesia 1996;10(4):502-6. - PubMed
Tempe 2001 {published data only}
    1. Tempe DK, Banerjee A, Virmani S, Mehta N, Panwar S, Tomar AS, et al. Comparison of the effects of a cell saver and low dose aprotinin on blood loss and homologous blood usage in patients undergoing valve surgery. Journal of Cardiothoracic and Vascular Anesthesia 2001;15(3):326-30. - PubMed
Trubel 1995 {published data only}
    1. Trubel W, Gunen E, Wuppinger G, Tschernko E, Gunen-Frank A, Staudacher M, et al. Recovery of intraoperatively shed blood in aortoiliac surgery: comparison of cell washing with simple filtration. Thoracic and Cardiovascular Surgeon 1995;43(3):165-70. - PubMed
Ubee 2010 {published data only}
    1. Ubee SS, Manikandan R, Gudimetla AR, Singh G. Cost benefits of intraoperative cell salvage in radical cystectomy. Indian Journal of Urology 2010;26(2):196-9. [DOI: 10.4103/0970-1591.65386] - DOI - PMC - PubMed
Ulrich 2014 {published data only}
    1. Ulrich C, Bauer A, Eberle T, Schaarschmidt J, Lucy J, Hausmann H. Effects of cell salvaged and directly retransfused mediastinal shed blood on the postoperative competency of the coagulation system after coronary artery bypass graft surgery. Interactive Cardiovascular and Thoracic Surgery 2014;19 (4):S719 (Abstract no. 005). [DOI: 10.1093/icvts/ivu292] - DOI
Vertrees 1996 {published data only}
    1. Vertrees RA, Conti VR, Lick SD, Zwischenberger JB, McDaniel LB, Shulman G. Adverse effects of postoperative infusion of shed mediastinal blood. Annals of Thoracic Surgery 1996;62(3):717-23. - PubMed
Vonk 2012 {published data only}
    1. Vonk AB, Muntajit W, Bhagirath P, Barneveld LJ, Romijn JW, Vroege R, et al. Residual blood processing by centrifugation, cell salvage or ultrafiltration in cardiac surgery: effects on clinical hemostatic and ex-vivo rheological parameters. Blood Coagulation & Fibrinolysis 2012;23(7):622-8. [DOI: ] - PubMed
Wang 2012 {published data only}
    1. Wang X, Ji B, Zhang Y, Zhu X, Liu J, Long C, et al. Comparison of the effects of three cell saver devices on erythrocyte function during cardiopulmonary bypass procedure - a pilot study. Artificial Organs 2012;36(10):931-5. [DOI: ] - PubMed
    1. Wang X. Comparison of the effects of three autotransfusion devices on erythrocyte function and clinical indicator during cardiopulmonary bypass procedure. Cardiology 2012;123 (Suppl 1):[no pagination]. [DOI: 10.1159/000341270] - DOI
Wang 2022 {published data only}
    1. Wang Z, Li S, Jia Y, Liu M, Yang K, Sui M, et al. Clinical prognosis of intraoperative blood salvage autotransfusion in liver transplantation for hepatocellular carcinoma: A systematic review and meta-analysis. Frontiers in Oncology 2022;12:985281. [DOI: ] - PMC - PubMed
Weltert 2013 {published data only}
    1. Weltert L, Nardella S, Rondinelli MB, Pierelli L, De Paulis R. Reduction of allogeneic red blood cell usage during cardiac surgery by an integrated intra- and postoperative blood salvage strategy: results of a randomized comparison. Transfusion 2013;53(4):790-7. [DOI: ] - PubMed
Whitlock 2013 {published data only}
    1. NCT01173822. Processed residual pump blood in cardiac surgery: the PRBC trial (PRBC). clinicaltrials.gov/ct2/show/NCT01173822 First posted: 2 August 2010 (retrospective).
    1. Whitlock R, Mathew J, Eikelboom J, Al-Saleh AM, Yuan F, Teoh K. Processed residual pump blood in cardiac surgery: the Processed Residual Blood in Cardiac surgery trial. Transfusion 2013;53(7):1487-92. [DOI: 10.1111/j.1537-2995.2012.03958.x.] [PMID: ] - DOI - PubMed
Wong 2002 {published data only}
    1. Wong JCL, Torella F, Haynes SL, Dalrymple K, Mortimer AJ, McCollum CN, on behalf of ATIS investigators. Autologous versus allogeneic transfusion in aortic surgery: a multicenter randomized clinical trial. Annals of Surgery 2002;235(1):145-51. - PMC - PubMed
Wu 2019 {published data only}
    1. Wu X, Ma X, Feng H, Huo J, Xing Z, Chen C, et al. Application of autologous blood transfusion in spine surgery and its influence on hemorheology and inflammatory factors. International Journal of Clinical and Experimental Medicine 2019;12(8):10579-87.
Xing 2014 {published data only}
    1. Xing YL, Wang YC. Influence of autologous and homologous blood transfusion on interleukins and tumor necrosis factor-alpha in peri-operative patients with esophageal cancer. Asian Pacific Journal of Cancer Prevention: APJCP 2014;15(18):7831-4. [DOI: ] - PubMed
Zacharopoulos 2007 {published data only}
    1. Zacharopoulos A, Apostolopoulos A, Kyriakidis A. The effectiveness of reinfusion after total knee replacement. A prospective randomised controlled study. International Orthopaedics 2007;31(3):303-8. - PMC - PubMed
Zacharowski 2022 {published data only}
    1. Zacharowski K, Zoller H, Steinbicker AU. Patient blood management and patient safety. Current Opinion in Anaesthesiology 2022;35(6):733-7. [DOI: 10.1097/ACO.0000000000001196] - DOI - PubMed
Zhou 2014 {published data only}
    1. Zhou LW, Li MQ, Wang XS, Wu Y, Ye F, Ye X. Application of controlled hypotension combined with autotransfusion in spinal orthomorphia. Anesthesia: Essays and Researches 2014;8(2):145-9. [DOI: ] - PMC - PubMed
Zhou 2020 {published data only}
    1. Zhou XY, Xu LF, Chang X, Sun L, Guo Z. Application of autologous platelet-rich plasma separation in cardiac valve replacement: a random clinical trial. Zhonghua wai ke za zhi [Chinese Journal of Surgery] 2020;58(12):924-8. [DOI: 10.3760/cma.j.cn112139-20191231-00647] [PMID: ] - DOI - PubMed

References to studies awaiting assessment

Aghdaii 2012 {published data only (unpublished sought but not used)}
    1. Aghdaii N, Kabiri M, Yazdanian F, Ghaffarinejad MH. Effect of retransfusion of heparin remaining in the salvaged blood on postoperative blood loss in coronary artery bypass grafting: comparison with homologous blood transfusion. Iranian Heart Journal 2012;13(2):24-34.
Bell 1992 {published data only}
    1. Bell K, Stott K, Sinclair CJ, Walker WS, Gillon J. A controlled trial of intra-operative autologous transfusion in cardiothoracic surgery measuring effect on transfusion requirements and clinical outcome. Transfusion Medicine 1992;2(4):295-300. [DOI: ] [PMID: ] - PubMed
Bouboulis 1994 {published data only}
    1. Bouboulis N, Kardara M, Kesteven PJ, Jayakrishnan AG. Autotransfusion after coronary artery bypass surgery: is there any benefit? Journal of Cardiac Surgery 1994;9(3):314-21. - PubMed
Cavolli 2011 {published data only}
    1. Cavolli R, Uymaz B, Memishaj S, Eren NT. Cell saver in off-pump surgery. Heart Surgery Forum 2011;1:s35.
ChiCTR‐IOR‐17010508 {published data only}
    1. ChiCTR-IOR-17010508. Perioperative lung protection of leucocyte filter with autologous blood cell salvage technology for elderly patients undergoing spinal surgery. www.chictr.org.cn/showprojen.aspx?proj=17884 Date of registration: 24 January 2017 (prospective).
Damgaard 2010 {published data only}
    1. Damgaard S, Nielsen CH, Andersen LW, Bendtzen K, Tvede M, Steinbrüchel DA. Cell saver for on-pump coronary operations reduces systemic inflammatory markers: a randomized trial. Annals of Thoracic Surgery 2010;89:1511-17. - PubMed
    1. NCT00159926. Cleansing of suction blood in cardiac surgery for reduced inflammatory response. www.clinicaltrials.gov/ct2/show/NCT00159926 First posted: 12 September 2005 (retrospective).
Dietrich 1989 {published data only}
    1. Dietrich W, Barankay A, Dilthey G, Mitto HP, Richter JA. Reduction of blood utilization during myocardial revascularization. Journal of Thoracic and Cardiovascular Surgery 1989;97(2):213-9. - PubMed
Fragnito 1995 {published data only}
    1. Fragnito C, Beghi C, Cavozza C, Saccani S, Contini SA, Barboso G. Autotransfusion of the blood drained from mediastinum in the course of myocardial revascularization. Acta Bio Medica: Atenei Parmensis 1995;66(5):195-201. - PubMed
Güzel 2016 {published data only}
    1. Güzel Y, Gürcan OT, Gölge UH, Dülgeroğlu TC, Metineren H. Topical tranexamic acid versus autotransfusion after total knee arthroplasty. Journal of Orthopaedic Surgery 2016;24(2):179-82. [DOI: ] [PMID: ] - PubMed
ISRCTN24531848 {published data only}
    1. ISRCTN24531848. Blood transfusion in lower limb arthroplasty: the safe and economical future. www.isrctn.com/ISRCTN24531848 Submission date: 12 September 2003 (retrospective). [DOI: 10.1186/ISRCTN24531848] - DOI
ISRCTN55488814 {published data only}
    1. ISRCTN55488814. Reduction of allogenic blood transfusion and increased activation of coagulation by re-infusion of post-operative autologous wound blood in patients undergoing total knee and total hip replacement. www.isrctn.com/ISRCTN55488814 Submission date 10 October 2011; registration date 12 March 2012 (retrospective). [DOI: 10.1186/ISRCTN55488814] - DOI
Lei 2022 {published data only}
    1. Lei B, Guo M, Deng X, He S, Lu X, Wang Y et al. Intraoperative cell salvage as an effective intervention for postpartum hemorrhage- evidence from a prospective randomized controlled trial. Frontiers in Immunology 2022;13:953334. [DOI: ] - PMC - PubMed
Liang 2015 {published data only}
    1. Liang J, Shen J, Chua S, Fan Y, Zhai J, Feng B, et al. Does intraoperative cell salvage system effectively decrease the need for allogeneic transfusions in scoliotic patients undergoing posterior spinal fusion? A prospective randomized study. European Spine Journal 2015;24(2):270-5. [DOI: ] - PubMed
Liu 2020 {published data only}
    1. ChiCTR-ICC-15007096. Intraoperative cell salvage in high bleeding risk cesarean section: a prospective randomized controlled multi-center clinical trial. www.chictr.org.cn/showproj.aspx?proj=11283 Date of registration: 18 September 2015 (prospective).
    1. Liu Y, Li X, Che X, Zhao G, Xu M. Intraoperative cell salvage for obstetrics: a prospective randomized controlled clinical trial. BMC Pregnancy and Childbirth 2020;20(1):452. [DOI: ] - PMC - PubMed
Martin 2009 {published data only}
    1. Martin A, Prenn M, Wohlgenannt O, Strempel A. Blood transfusion from reinfusion systems in TKA - comparison of different wound drainage techniques. Journal of Bone and Joint Surgery. British volume (Proceedings) 2009;91-B (Suppl I):5-b. [URL: online.boneandjoint.org.uk/doi/abs/10.1302/0301-620X.91BSUPP_I.0910005b]
Matkovic 2010 {published data only}
    1. Matkovic M, Vuksanovic M, Putnik S. The efficacy of intraoperative cell salvage during coronary artery bypass grafting. European Journal of Medical Research 2010;1:223 (ESC-ID: 1242).
Morgenschweis 2011 {published data only}
    1. Morgenschweis K, Gierth T, Hering R. Effects of cell saver autologous blood transfusion on allogeneic blood transfusion in patients undergoing primary hip and knee replacement. Transfusion Alternatives in Transfusion Medicine 2011;12(1):Poster no. 26. [DOI: 10.1111/j.1778-428X.2011.01149.x] - DOI
Murphy 2004 {published data only}
    1. Murphy GJ, Allen SM, Unsworth-White J, Lewis CT, Dalrymple-Hay MJ. Safety and efficacy of perioperative cell salvage and autotransfusion after coronary artery bypass grafting: a randomized trial. Annals of Thoracic Surgery 2004;77(5):1553-9. - PubMed
Narula 2015 {published data only}
    1. Narula J, Kiran U, Kapoor PM, Choudhury M, Chowdhury UK. Intra-operative autologous donation regulates increase in thoracic fluid content in patients undergoing heart valve replacement on cardiopulmonary bypass. Vox Sanguinis 2015;109 (Suppl 1):373-4.
NCT00950547 {published data only}
    1. NCT00950547. ICU cell saver to reduce blood transfusions in cardiac. www.clinicaltrials.gov/ct2/show/NCT00950547 First posted: 31 July 2009 (prospective).
NCT01468129 {published data only}
    1. NCT01468129. Cell saver use in bilateral total hip Arthroplasty (THA). clinicaltrials.gov/ct2/show/NCT01468129 First posted: 9 November 2011 (prospective).
NCT02058134 {published data only}
    1. NCT02058134. The CardioPAT project: a randomized trial. clinicaltrials.gov/ct2/show/NCT02058134 First posted: 7 February 2014 (retrospective).
Rainaldi 1998 {published data only}
    1. Rainaldi MP, Tazzari PL, Scagliarini G, Borghi B, Conte R. Blood salvage during caesarean section. British Journal of Anaesthesia 1998;80(2):195-8. [DOI: 10.1093/bja/80.2.195] [PMID: ] - DOI - PubMed
Ritter 1994 {published data only}
    1. Ritter MA, Keating EM, Faris PM. Closed wound drainage in total hip or total knee replacement. A prospective, randomized study. Journal of Bone and Joint Surgery. American Volume 1994;76(1):35-8. - PubMed
Shen 2013 {published data only}
    1. Shen J, Liang J, Chua S. Does intraoperative cell salvage system effectively decrease the need for allogeneic transfusions in scoliotic patients undergoing posterior spinal fusion: a prospective randomized study. European Spine Journal 2013;1:s758-s759 (P101). [DOI: 10.1007/s00586-013-2947-6] - DOI - PubMed
Simpson 1994 {published data only}
    1. Simpson MB, Murphy KP, Chambers HG, Bucknell AL. The effect of postoperative wound drainage reinfusion in reducing the need for blood transfusions in elective total joint arthroplasty: a prospective, randomized study. Orthopedics 1994;17(2):133-7. - PubMed
Sintes 2009 {published data only}
    1. Sintes D, Pijoan M, Mansilla R, Esteva E, Martinez L. The quality and safety of reinfused drainage blood after total knee arthroplasty. European Journal of Anaesthesiology 2009;45:85.
Skoura 1997 {published data only}
    1. Skoura H, Anastasiou E, Moshou A, Katsioulas A, Kostaki S. Value of autologous blood for intra-operative massive bleeding. European Journal of Anaesthesiology 1997;14(1):74-5.
Srndic 2014 {published data only}
    1. Srndic E, Kiessling AH, Guo F, Keller H, Beiras-Fernandez A, et al. Coronary artery revascularization with a minimized extracorporeal circulation system (MECC): the inflammatory response in comparison to conventional cardiopulmonary bypass. Thoracic and Cardiovascular Surgeon 2014;62 (Suppl 1):[no pagination]. [DOI: 10.1055/s-0034-1367384] - DOI
Stamenic 2009 {published data only}
    1. Stamenic S, Mitkovic M, Stanojlovic M, Jevtic R, Velickovic K. Postoperative autotransfusion in total hip arthroplasty. European Journal of Anaesthesiology 2009;45:87 (6AP2-9).
Washington 2009 {published data only}
    1. Washington B, Liakonis C, Pagnanelli R, Salerno C, Barnett L, Lonquist J, et al. Post-operative cell salvage reduces allogeneic RBC transfusion rate in patients undergoing cardiovascular surgery. Transfusion 2009;49(10):2257-8.
Wiefferink 2007 {published data only}
    1. Wiefferink A, Weerwind PW, Heerde W, Teerenstra S, Noyez L, Pauw BE, et al. Autotransfusion management during and after cardiopulmonary bypass alters fibrin degradation and transfusion requirements. Journal of Extra-Corporeal Technology 2007;39(2):66-70. - PMC - PubMed
Yu 2022 {published data only}
    1. Yu YF, Cao YD. Effect of intraoperative cell rescue on bleeding related indexes after cesarean section. World Journal of Clinical Cases 2022;10(8):2439-46. [DOI: ] - PMC - PubMed

References to ongoing studies

ChiCTR1800018118 {published data only}
    1. ChiCTR1800018118. A multicenter prospective randomized controlled trial for the safety of intraoperative salvaged blood in the spinal metastasis surgery. www.chictr.org.cn/showprojen.aspx?proj=30606 Date of registration: 31 August 2018 (prospective).
DRKS00021914 {published data only}
    1. DRKS00021914. Haemodynamic relevance of cardiotomy suction blood for the systemic vascular resistance and requirement of catecholamines. drks.de/search/en/trial/DRKS00021914 Date of registration in DRKS: 04 June 2020 (retrospective).
NCT02595385 (CONSERVE) {published data only}
    1. NCT02595385. Blood conservation in adult cardiac surgery, what is the way forward in today's practice? (CONSERVE). clinicaltrials.gov/ct2/show/study/NCT02595385 First posted: 3 November 2015 (retrospective).
NCT03429790 {published data only}
    1. NCT03429790. Cell salvage during Caesarean section (CSCS). clinicaltrials.gov/ct2/show/NCT03429790 First posted: 12 February 2018 (prospective).
NCT04574128 {published data only}
    1. NCT04574128. Retransfusion or not of cardiotomy blood. www.clinicaltrials.gov/ct2/show/NCT04574128 First posted: 5 October 2020 (prospective).
NCT04922307 (RESTRICT) {published data only}
    1. NCT04922307. Reduction of allogenic blood transfusion in locally advanced kidney cancer (RESTRICT). www.clinicaltrials.gov/ct2/show/NCT04922307 First posted: 10 June 10 2021 (prospective).
NCT05612477 {published data only}
    1. NCT05612477. Blood salvage in orthotopic liver transplantation with HCC (SOLT). clinicaltrials.gov/ct2/show/NCT05612477 First posted: 10 November 2022 (prospective).

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