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Salvage blood transfusion refers to the process of collecting and re-infusing a patient’s own shed blood during or after surgery or trauma. This is a type of autologous transfusion, typically performed using specialized devices called cell savers or through intraoperative/postoperative drainage systems.

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It is an alternative to donor (allogeneic) blood transfusion and is particularly useful when significant blood loss is anticipated.

Types

1. Intraoperative Cell Salvage (ICS):
   • Blood lost during surgery is suctioned, filtered, washed, and reinfused.
2. Postoperative Salvage:
   • Blood from surgical drains is collected, filtered, and returned.
3. Unwashed Salvage (e.g., in orthopedics, cardiac surgery):
   • Shed blood directly reinfused after filtration (not routinely recommended due to risk of contaminants).

Indications

• Surgeries with high blood loss risk:
  • Cardiac, vascular, orthopedic (hip/knee replacement, spine), hepatobiliary, trauma, transplantation.
• Patients with rare blood groups or multiple alloantibodies.
• Situations where donor blood is limited/unavailable.

Contraindications

• Absolute:
  • Contaminated operative field (fecal/urinary contamination, infected wound).
  • Malignancy surgery (risk of tumor cell dissemination, though filters can reduce).
• Relative:
  • Use of certain irrigants (e.g., povidone-iodine).
  • Hemoglobinopathies.

Procedure (Cell Saver System)

1. Blood collected from operative field via suction (heparinized saline used to prevent clotting).
2. Passed through filters to remove debris.