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Intraoperative blood salvage, also known as autologous blood transfusion or cell salvage, is a medical procedure involving recovering blood lost during surgery and re-infusing it into the patient. It is a major form of autotransfusion. It has been used for many years and gained greater attention over time as risks associated with allogenic (separate-donor) blood transfusion have seen greater publicity and more fully appreciated. Several medical devices have been developed to assist in salvaging the patient's own blood in the perioperative setting. These are used frequently in cardiothoracic and vascular surgery, in which blood usage has traditionally been high. With a greater effort to avoid adverse events due to transfusion there has also been an emphasis on blood conservation (see bloodless surgery). ==Background== Providing safe blood for transfusion remains a challenge despite advances in preventing transmission of hepatitis B, hepatitis C, AIDS/HIV, West Nile virus (WNV), and transfusion-transmitted bacterial infection. Human errors such as misidentifying patients and drawing blood samples from the wrong person present much more of a risk than transmissible diseases. Additional risks include transfusion related acute lung injury (TRALI), a potentially life-threatening condition with symptoms such as dyspnea, fever, and hypotension occurring within hours of transfusion, and also transfusion-associated immunomodulation, which may suppress the immune response and cause adverse effects such a small increase in the risk of postoperative infection. Other risks such as variant Creutzfeldt-Jakob disease (vCJD), an invariably fatal disease, remain worrisome. Blood centers worldwide have instituted criteria to reject donors who may have been exposed to vCJD. Screening for transmissible diseases and deferral policies for vCJD designed to improve safety have contributed to shrinking the donor pool. Blood shortages exist in the United States and worldwide. In many industrialized countries 5% or less of the eligible population are blood donors. As a result, the global medical community has increasingly moved from allogenic blood (blood collected from another person) towards autologous infusion, in which patients receive their own blood. Another impetus for autologous transfusion is the position of Jehovah's Witnesses on blood transfusions. For religious reasons, Jehovah's Witnesses will not accept any allogeneic transfusions from a volunteer's blood donation, but may accept the use of autologous blood salvaged during surgery to restore their blood volume and homeostasis during the course of an operation, although not autologous blood donated beforehand. There are other religious/ non-religious individuals besides Jehovah's Witnesses that accept Intraoperative blood salvage due to personal choice. 抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)』 ■ウィキペディアで「Intraoperative blood salvage」の詳細全文を読む スポンサード リンク
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