Cell salvage is a method of collecting blood that you may lose during an operation. The blood collected is filtered and washed to remove contaminants. If needed, it can be given back to you through a small tube into a vein. Your blood will only ever be given to you and cannot be used for someone else.
Cell salvage is a technique that is well established in many types of surgery and is used regularly at Southmead Hospital.
Why might I need a blood transfusion?
It is normal when having a caesarean section, to lose some blood during the procedure. Most of the time, the blood lost can be replaced with other fluids. Your body will make new red blood cells over the next few weeks.
However, it may be necessary to replace the blood by giving a blood transfusion. Blood used for these transfusions can be:
- A supply of donor blood from volunteers
- Your own blood using the cell salvage method
- Both donor blood and your own blood
What are the benefits of cell salvage?
The use of cell salvage can reduce the need for a blood transfusion of donor blood.
Although risks associated with receiving a blood transfusion from a donor are low, there are still very small risks of infection being passed on. Having your own blood returned to you removes these risks and may decrease your length of hospital stay.
Donor blood is stored before transfusion and this can affects its properties: for instance, stored blood does not carry oxygen as well. Having your own blood returned to you straight away eliminates these problems.
The cell salvage technique is sometimes seen as an acceptable alternative for those who will not accept a transfusion using donated blood as cell salvage is a continuous circuit.
What are the risks of cell salvage and how can they be prevented?
1. Amniotic Fluid Embolism
There is a theoretical risk that the fluid that surrounds the baby, amniotic fluid, could be returned to the mother. This could potentially cause a condition called amniotic fluid embolism that can cause harm through an allergic reaction.
However, the washing and filtering mechanisms of the machine are very effective in removing amniotic fluid. Cell salvage has been used in caesarean section for many years and there is no evidence of this happening.
2. Antibody formation
There is a risk that the baby’s blood can get into your bloodstream. This may cause antibodies to develop that can harm the baby in future pregnancies. The most common blood group where this happens is if you are RhD negative and your baby is RhD positive.
There is always risk of mixing mother and baby’s blood during a caesarean section or delivery, even when cell salvage is not used. Therefore, to prevent antibodies forming, all mothers who have Rhesus negative blood group have a blood test after the operation. A drug called Anti-D Immunoglobulin is given to mothers whose baby has Rhesus positive blood group to prevent problems in future pregnancies. This is given irrespective of whether cell salvage has been used and can be given up to 72 hours after the operation.
What does this mean for you?
This information will help you make an informed decision on receiving your own blood back (cell salvage) during surgery. If you have any questions about cell salvage, which are not answered by the leaflet, please discuss them with your Anaesthetist.
For further information about cell salvage visit: www.transfusionguidelines.org
The use of cell salvage in caesarean sections has been endorsed by:
- National Institute for Health and Clinical Excellence (NICE)
- Confidential Enquiry into Maternal and Child Health (CEMACH)
- Obstetric Anaesthetists Association (OAA)
- Association of Anaesthetists of Great Britain and Ireland (AAGBI)