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Ann Thorac Surg 1998;65:1248-1254
© 1998 The Society of Thoracic Surgeons

Shed Mediastinal Blood Transfusion After Cardiac Operations: A Cost-Effectiveness Analysis

^a Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
^b Division of Cardiovascular and Thoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA

Accepted for publication December 5, 1997.

Address reprint requests to Mr Kilgore, Department of Pathology, The University of Alabama at Birmingham, P230 West Pavilion, 619 South 19th St, Birmingham, AL 35233-7331
e-mail: (kilgore{at}wp.path.uab.edu)

Background. Cardiac surgical patients consume a significant fraction of the annual volume of allogeneic blood transfused. Scavenged autologous blood may serve as a cost-effective means of conserving donated blood and avoiding transfusion-related complications.

Methods. This study examines 834 patients after cardiac operations at the University of Alabama Hospital. Data were collected on patients receiving unwashed, filtered, autologous transfusions from shed mediastinal drainage and those receiving allogeneic transfusions. The data were incorporated into clinical decision models; confidence intervals for parameters were estimated by bootstrapping sample statistics. Costs were estimated for transfusing both allogeneic and autologous blood.

Results. The study found a 54% reduction in transfusion risk or a mean reduction of 1.41 allogeneic units per case (95% confidence interval, 1.04 to 1.79 units). The process saved between $49 and $62 per case.

Conclusions. The use of autologous blood has the potential to significantly reduce the costs and risks associated with transfusing allogeneic blood after cardiac operations.

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