Ranking the effectiveness of autologous blood conservation measures through validated modeling of independent clinical data.

Abstract:

BACKGROUND:Future supply with allogeneic blood transfusions faces several crucial challenges that warrant thorough (re-)evaluation of existing alternatives. Meta-analyses have indicated a significant potential for autologous blood conservation (ABC) measures to reduce the need for allogeneic blood transfusions. The quality of currently available studies, however, prohibits definite conclusions. Under these circumstances, mathematical modeling offers unique opportunities to compare various ABC measures and to test the impact of different variables on efficacy and effectiveness. STUDY DESIGN AND METHODS:We performed an extensive search for clinical ABC studies, focusing on acute normovolemic hemodilution (ANH), intraoperative blood salvage (IBS), or preoperative autologous deposit (PAD). Only ABC studies providing a minimum set of clinical variables were included. Using a clinically validated mathematical model, we then calculated maximal allowable blood loss (efficacy) and increase in red blood cell (RBC) mass (effectiveness) to rank the three techniques. RESULTS:We identified 21 clinical ABC studies, including 3926 patients, as suitable for our model. Our model shows that IBS with high recovery rates is the most efficacious and effective ABC measure. PAD will reveal nearly similar efficacy and effectiveness, only if sufficient time for RBC regeneration has passed and if 4 PAD units or more are available. Our model further demonstrates that ANH as well as IBS with low recovery rates are the least efficacious and effective alternatives. CONCLUSIONS:IBS appears to be the most efficacious and effective ABC measure. PAD can only reduce the need for allogeneic blood transfusions under certain circumstances. ANH does not appear to play an important role in ABC.

journal_name

Transfusion

journal_title

Transfusion

authors

Singbartl G,Held AL,Singbartl K

doi

10.1111/trf.12233

subject

Has Abstract

pub_date

2013-12-01 00:00:00

pages

3060-79

issue

12

eissn

0041-1132

issn

1537-2995

journal_volume

53

pub_type

杂志文章
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    journal_title:Transfusion

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    doi:10.1046/j.1537-2995.1984.24384225030.x

    authors: Kalmin ND,Liles BA

    更新日期:1984-05-01 00:00:00

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    abstract::A family is described in which two members of the second generation are of the phenotype LW3. In the course of the investigation the mother of the LW3 propositus was at first believed to be phenotypically LW3 as well. Eventually, it was shown that she is, in fact, phenotypically LW2 but that her R-1 (no D), LWlw, geno...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1978.18478251248.x

    authors: Behzad O,Pothiawala M,Rolih SD,Issitt PD,Lee CL

    更新日期:1978-07-01 00:00:00

  • Where now for transfusion: the evolution of a paradigm and its logical progression.

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    journal_title:Transfusion

    pub_type: 历史文章,杂志文章

    doi:10.1111/trf.13581

    authors: Farrugia A,Starr D

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1979.19680104100.x

    authors: Britten AF,Geurtze DG

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    journal_title:Transfusion

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    doi:10.1111/trf.12794

    authors: Raval JS,Mazepa MA,Brecher ME,Park YA

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1979.19479250187.x

    authors: Kosmidis PA,Lewandowski S

    更新日期:1979-07-01 00:00:00

  • Blood wastage reduction using Lean Sigma methodology.

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2010.02679.x

    authors: Heitmiller ES,Hill RB,Marshall CE,Parsons BJ,Berkow LC,Barrasso CA,Zink EK,Ness PM

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1998.381098440854.x

    authors: Yerly S,Pedrocchi M,Perrin L

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  • Mitochondrial damage-associated molecular patterns as potential proinflammatory mediators in post-platelet transfusion adverse effects.

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/trf.13535

    authors: Yasui K,Matsuyama N,Kuroishi A,Tani Y,Furuta RA,Hirayama F

    更新日期:2016-05-01 00:00:00

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    journal_title:Transfusion

    pub_type: 临床试验,杂志文章

    doi:10.1046/j.1537-2995.1998.38198141494.x

    authors: Stohlawetz P,Hergovich N,Stiegler G,Eichler HG,Höcker P,Kapiotis S,Jilma B

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    journal_title:Transfusion

    pub_type: 杂志文章

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.2003.00399.x

    authors: Wang B,Schreiber GB,Glynn SA,Nass CC,Smith JW,Higgins MJ,Hutching ST,Wright DJ,McEntire RL,Murphy EL,Retrovirus Epidemiology Donor Study.

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    journal_title:Transfusion

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2007.01546.x

    authors: Thon JN,Schubert P,Duguay M,Serrano K,Lin S,Kast J,Devine DV

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    journal_title:Transfusion

    pub_type: 历史文章,杂志文章

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2005.00577.x

    authors: Zou S,Musavi F,Notari EP 4th,Fujii KE,Dodd RY,ARCNET Study Group.

    更新日期:2005-10-01 00:00:00

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    journal_title:Transfusion

    pub_type: 杂志文章

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  • Transfusion-related acute lung injury caused by an NB2 granulocyte-specific antibody in a patient with thrombotic thrombocytopenic purpura.

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    journal_title:Transfusion

    pub_type: 杂志文章

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  • Probability of receiving testing in a national lookback program: the English HCV experience.

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.2002.00171.x

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    更新日期:2002-09-01 00:00:00

  • Transfusion of frozen erythrocytes from a donor with sickle trait.

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1984.24284173352.x

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  • Natural anti-A and anti-B of the ABO system: allo- and autoantibodies have different epitope specificity.

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2011.03381.x

    authors: Obukhova P,Korchagina E,Henry S,Bovin N

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2006.00743.x

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    journal_title:Transfusion

    pub_type: 杂志文章

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    更新日期:2005-11-01 00:00:00

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/trf.13375

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    更新日期:2016-01-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1111/trf.14807

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    pub_type: 杂志文章

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    更新日期:1976-11-01 00:00:00

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    更新日期:1980-01-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.2000.40030361.x

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    更新日期:2000-03-01 00:00:00