Impact of cell saver during cardiac surgery on blood transfusion requirements: a systematic review and meta-analysis

Murtadha Al Khabori, Arwa Al Riyami, Mohammad Salman Siddiqi, Ziyab Khan Sarfaraz, Edem Ziadinov, Hilal Al Sabti*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Citations (Scopus)

Abstract

Objective: We performed a systematic review and meta-analysis of randomized clinical trials on adult patients undergoing cardiac surgery and compared the rates of red blood cell (RBC), platelet and fresh frozen plasma (FFP) transfusion between the cell saver (CS) and the standard of care groups. Methods: MEDLINE ®, The Cochrane Central Register of Controlled Trials (CENTRAL), American Society of Hematology (ASH) and bibliographies of relevant studies were searched. We used random-effect model. Results: Our search strategy returned 624 citations, of which 15 studies were selected. The use of CS did not decrease the rate of RBC transfusion (odds ratio [OR]: 0·69; 95% CI: 0·48–1·00), albeit with a substantial heterogeneity (I2 = 60%). The year of publication explained most of the heterogeneity (P for subgroup effect <0·001). Although the rate of platelet transfusion was lower in the CS group, the difference was not statistically significant (OR: 0·83; 95% CI: 0·57–1·2; I2 = 0%). The rate of FFP transfusion was numerically higher in the CS group; however, this difference did not reach statistical significance (OR: 1·26; 95% CI: 0·82–1·94; I2 = 15%). Only two studies scored five on the Jadad score. There was no indication of a publication bias using the funnel plot and Egger test (P = 0·34, 0·87, and 0·62 for RBC, platelet and FFP, respectively). Conclusion: The use of CS during cardiac surgery does not have an impact on the rates of RBC, platelet and FFP transfusion; however, this should be interpreted in the light of the study limitations.

Original languageEnglish
Pages (from-to)553-565
Number of pages13
JournalVox Sanguinis
Volume114
Issue number6
DOIs
Publication statusPublished - Jan 1 2019

Keywords

  • blood transfusion
  • meta-analysis
  • operative blood salvage

ASJC Scopus subject areas

  • Hematology

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