Abstract

Objective: Using the cell saver (CS) in all elective open repairs for abdominal aortic aneurysms (AAA) is not recommended. We sought to define the group of patients in whom the use of the CS would be most beneficial.

Methods: We retrospectively studied all patients undergoing elective open repair (OR) for AAA. Using data from the centre’s clinical database, we analysed demographic and analytic variables, the anatomy and size of the aneurysm, and surgical and postoperative data. We separated patients into those who required transfusion of 0 or 1 blood unit and those who required 2 blood units or more. Secondary outcomes were risk factors for blood loss during surgery and surgical complications.

Result: Between March 2010 and February 2014, 105 patients (93.4% males) underwent OR for an AAA. Mean values for data collected included age of 71 years, body mass index (BMI) of 27.5 (95% CI:26.6-28.3), preoperative haemoglobin (Hb) of 13.9 g/dL (95% CI:135.6-142.7), and aneurysm diameter of 62.9 mm (95% CI:59.8-66.1). Thirty-nine patients (37.1%) required a transfusion of 2 or more blood units. Predictive factors for needing at least 2 BUs were BMI ≥ 27.5 (RR:1.96), a preoperative Hb ≤ 13mg/dL (RR:2.46) and an aneurysm size ≥ 66.5 mm (RR:3.89).

Conclusion: High BMI, low Hb and large aneurysms are risk factors of substantial blood loss during AAA surgery and allow us to select patients in whom the cell saver is more beneficial.