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

Urology. 2015 Dec;86(6):1153-8. doi: 10.1016/j.urology.2015.09.008. Epub 2015 Sep 24.

Abstract

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.

MeSH terms

  • 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
  • Warm Ischemia