Hemodilution and Autotransfusion in Bph Surgery

Abstract

Blood loss during prostatic surgery is related to the size of the prostatic adenoma and the need to carry out transfusions varies from 6.5% in transurethral surgery (Mebust) to 65% in open surgery (Meyhoff), with all the risks involved in homologous transfusions (hepatitis A, B, non A-non B, cytomegalovirus, Epstein - Barr virus, HIV-Aids). Autotransfusion, apart from reducing such serious risks, has the undoubted advantage of hemodilution. It has been demonstrated that reduction of the hematocrit improves oxygen supply to the tissues. The programme of autodonation-hemodilution set up at the Urology Department in Treviso in 1985 has resulted in average pre-operative hemoglobin values of 12.6 g compared to 14.4 in pre-donation, with a pre-deposit per patient of 1–3 bags of concentrated erythrocytes. In 1990, 70% of patients operated received only autologous blood, while donor transfusions were given in 18 out of 298 operations (6%). This method is extremely advantageous for improving tissue perfusion, for saving blood and reducing transfusional and thromboembolic risks. It also provides economic-social savings and is always well accepted, and is indeed greatly requested today, by patients being operated.