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Whole blood autotransfusion linked to fewer fluids, lower costs

Key clinical point: Autotransfusion appears to be safe and cost-effective in trauma patients.

Major finding: Patients who underwent autotransfusion (AT) vs. no AT received significantly less allogeneic packed red blood cells (10.3 vs. 12.1 units), platelets (5.2 vs. 7.9 units), and fresh frozen plasma (6.1 vs. 8.2 units) than patients who did not undergo transfusion. Therapy expenses ($8,794 vs. $10,427) and hospital costs ($42,156 vs. $43,963) were also lower without any appreciable difference in outcomes.

Data source: Six-year, multi-institutional, retrospective study of 272 trauma patients, evenly divided between receiving AT and not receiving AT.

Disclosures: Dr. Rhee reported having no relevant financial disclosures.


 

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PHILADELPHIA – Early whole-blood autotransfusion of severely injured trauma victims’ own blood, while employed frequently in the military, has been rare in civilian populations, but a recent trial has found it to be safe, effective, and less costly than customary allogeneic transfusions.

Dr. Peter Rhee, chief of trauma, critical care, burns, and emergency surgery at the University of Arizona Medical Center, Tucson, reported on results from a 6-year retrospective study at the annual meeting of the American Association for the Surgery of Trauma. The study evaluated 272 trauma patients in two centers in Tucson and Los Angeles County who required transfusions upon presentation in the emergency department.

Dr. Peter Rhee

“We did this because there is a lot of concern in animal and also human ex vivo laboratory type experiments [regarding] complications from coagulopathy and possibly even increasing the inflammatory processes. So we looked at those types of complications and found that there were no clinically significant complications we could identify in regard to coagulopathy or inflammatory processes with AT [autotransfusion],” Dr. Rhee said.

“But what we also found was that since getting a patient’s own blood back costs less, hospital costs would also be less.”

Patients who underwent AT vs. no AT received significantly less allogeneic packed red blood cells (10.3 vs. 12.1 units), platelets (5.2 vs. 7.9 units), and fresh frozen plasma (6.1 vs. 8.2 units) than patients who did not undergo transfusion.

The investigators reported that AT cost approximately $8,794 per patient vs. $10,7427 for allogeneic transfusions. Hospital costs ($42,156 vs. $43,963) were also lower without any appreciable difference in outcomes.

The trial population was split evenly between those receiving AT and those who did not. Demographics and injury characteristics were similar between the two groups.

“Autologous autotransfusion of blood collected through the chest tube was safe, is associated reduced allogeneic transfusion, and is associated with decreased hospital costs,” Dr. Rhee said. “I think this trial provides safety data for us to go on and do a larger prospective, multicenter study.”

Dr. Rhee reported having no relevant financial disclosures.

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