In abdominal myomectomy, cell salvage may reduce transfusions

May 22, 2018|Hematology and Oncology

REPORTING FROM SGS 2018

ORLANDO – Cell salvage may help reduce the need for allogeneic blood transfusion in patients undergoing abdominal myomectomy, according to findings from a retrospective cohort study.

Of 138 women who underwent abdominal myomectomy, 52 had no cell salvage and 86 had cell salvage ordered. Of those who had cell salvage ordered, 60 had salvage fully set up and 26 had salvage on standby; 46 of the 60 with full set-up had autologous blood returned, and of those, 14 required subsequent allogeneic transfusion of more than 20 U of blood, Julian A. Gingold, MD, reported at the annual scientific meeting of the Society of Gynecologic Surgeons.

“Estimated blood loss was greater in the patients who had cell salvage ordered (711 mL vs. 391 mL; P = .002), although – surprisingly – the overall rate of transfusion was comparable [between the groups] both intraoperatively and within 1 week after surgery (23% and 17%, respectively), with a nonsignificant difference in odds ratios (OR, 1.44; P = .519), said Dr. Gingold of the Women’s Health Institute, Cleveland Clinic Foundation.

Notable differences between those who did and those who did not have cell salvage ordered included the number of patients with fibroids weighing more than 250 g (52% vs. 13%) and with five or more total fibroids (83% vs. 56%), he said.

“And interestingly, reproductive surgeons were less likely (than general surgeons) to order cell salvage,” he said.

Surgery was performed by a reproductive surgeon in 25% of cases in the cell salvage group vs. in 67% of cases in the non–cell salvage group.

The finding of comparable allogeneic transfusion requirement between the two groups despite differences in blood loss and “arguably less complex surgeries [in those] without cell salvage” was striking, Dr. Gingold said.