J.Jpn. Surg. Soc.. 79(12): 1535-1542, 1978

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Original article

CLINICAL EVALUATION OF EXTRACORPOREAL CIRCULATION WITH AUTOLOGOUS BLOOD TRANSFUSION

Since 1973 to date, open heart surgery without blood prime was performed on 95 adult patients in our departement. Among these operations, 34 cases of ASD closure and 33 cases of open mitral commissulotomy were selected because they were comparable operations in terms of severity. These cases were divided into three groups according to their expected hematocrit value of 26±2% during the extracoropreal circulation. Group I, 17 cases ; Primed with diluent only and heparinized autologous blood was withdrawn through venous drainage at the onset of perfusion and returned to the patient after the perfusion. The volume of the autologous blood withdrawn was 400-1000 ml. Group II, 28 cases ; the bypass circuit and Oxygenator were filled only. Group III, 22 cases ; Cardiopulmonary bypass with diluted homologous blood.
There were no differences among the three groups in hematocrit, serum electrolytes or serum protein during the extracorporeal circulation and postoperative recovery period. The average total blood volume used during the operation and postoperatively was 250 ml in group I, 310 ml in group II, and 1400 ml in group III. The blood requirement was reduced, therefore, to 80% in groups I and II compared to group III. The hemodilution can be carried out without noticeable disadvantage when the hematocrit value is over 20% .
The extracorporeal circulation mthod with autologus blood transfusion will be a valuable one in the era of increasing homologous blood demand articipated in the near future.

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