Short-term Outcomes of Intraoperative Cell Saver Transfusion During Open Partial Nephrectomy

• Published in: Urology (Ridgewood, N.J.) Vol. 86; no. 6; pp. 1153 - 1158
• Main Authors: Lyon, Timothy D, Ferroni, Matthew C, Turner, Robert M., II, Jones, Cameron, Jacobs, Bruce L, Davies, Benjamin J
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2015
• Subjects: Aged; Blood Loss, Surgical; Blood Transfusion, Autologous - adverse effects; Carcinoma, Renal Cell - surgery; Female; Follow-Up Studies; Humans; Kidney Neoplasms - surgery; Length of Stay; Male; Middle Aged; Neoplasm Recurrence, Local - etiology; Nephrectomy - adverse effects; Nephrectomy - methods; Operative Blood Salvage - adverse effects; Operative Time; Retrospective Studies; Time Factors; Treatment Outcome; Urology; Warm Ischemia
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2015.09.008

Objective To determine whether transfusion using the Cell Saver system is associated with inferior outcomes in patients undergoing open partial nephrectomy. Methods All patients who underwent open partial nephrectomy by a single surgeon (BJD) from August 2008 to April 2015 were retrospectively identified. Operations were grouped and compared according to whether they included a transfusion using the Cell Saver intraoperative cell salvage system. Results Sixty-nine open partial nephrectomies in 67 patients were identified. Thirty-three procedures (48%) included a Cell Saver transfusion. Most tumors were clear cell renal cell carcinoma (62%) and stage T1a (68%). There were no significant differences between groups for any measured clinical or pathologic characteristics. Operations including a Cell Saver transfusion were longer (141 vs 108 minutes, P  <.001), had significantly greater blood loss (600 vs 200 mL, P  <.001), and had longer median renal ischemia times (15 vs 10 minutes, P  = .03). There were no significant differences in postoperative complication rate (21% vs 17%, P  = .83) or median length of hospital stay (3 vs 3 days, P  = .09). At a median follow-up of 23 months (interquartile range: 8-42 months), 1 patient in the non-Cell Saver transfusion group had cancer recurrence. There was no metastatic progression or cancer-specific mortality in either group. Conclusion Cell Saver transfusion during open partial nephrectomy was not associated with inferior outcomes with short-term follow-up, and no patients developed metastatic disease.