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Serious hazards of transfusion: abstracts from Serious Hazards of Transfusion Annual Symposium, London July 2013, and launch of the Annual SHOT Report 2012 (available on the website www.shotuk.org from 11 July 2013)

NO.: 1 An observational study looking at the benefits of ‘MicroTransfusions’ of cell salvaged blood in reducing the need for Allogenic Blood A. Bhalla, H. Robinson, M. Clement-Jones, M. Riley, S. Mallaiah & C. Chevannes Anaesthetic Department, Liverpool Women’s Hospital, Liverpool, UK Introduction: The advantages of cell salvage in obstetric haemorrhage are becoming more widely recognised. However, for cases where only small volumes of blood are processed, is it worth returning to the patient? Method: We collected data from caesarean sections over 6 months. We identified all patients who had received any form of transfusion: autologous, allogenic or both, and analysed them to understand the reasons and justifications for each transfusion. We aimed to see if there was a correlation between patients having cell salvaged blood in theatre and those not requiring allogenic blood on the ward prior to discharge. Microtransfusions, i.e. small volumes of salvaged blood returned in patients who would not have been deemed to require transfusion, were specifically looked at. Results: Our cohort compromised 950 caesareans of which: 80 patients (8·4%) received some form of transfusion, 36 (45%) patients received only cell salvaged blood, 35 (44%) patients were given allogenic blood, and 9 (11%) required both. Of the 35 patients requiring allogenic blood only, 14 patients were transfused at least 1 day post-operatively. These patients had initial haemoglobin 9·1–13·6 g dL−1 and an average estimated blood loss of 878 mL. The allogenic blood requirement was 2–5 units on the ward. Of the 36 patients receiving salvage blood only, 15 were microtransfusions of less than 250 mL. These patients would not have ordinarily received any blood transfusion and were only transfused as salvaged blood had been collected and processed and was hence available. The pre-operative haemoglobin of these patients was 9·4–12·8 g dL−1 and average estimated blood loss was 1200 mL. Discussion: As the incidence of obstetric haemorrhage requiring transfusion is low, despite a large initial case series the actual numbers to analyse are small. However from an observational point, the data suggests microtransfusions of cell salvage blood may be protective against post-partum anaemia requiring allogenic blood.