Transfusion requirements in elective open abdominal aortic aneurysm repair: a network review of practice

Abstract

Introduction: Patients undergoing elective open abdominal aortic aneurysm (AAA) repair are considered a high-risk group for transfusion, with transfusion rates quoted around 15%. In the context of an NHS blood transfusion (NHSBT) Amber Alert, it is suggested that surgeries with a high risk of transfusion (>15%) are postponed unless otherwise clinically indicated. This review of network elective open AAA activity aimed to improve our understanding of transfusion requirements and risk profile. Methods: National Vascular Registry data for patients undergoing elective open AAA repair in the Dorset and Wiltshire Vascular Network (DWVN) between January 2019 and February 2022 inclusive were retrospectively reviewed and cross-referenced with electronic patient records, pathology results, transfusion database and theatre records. Results: Ninety patients (seven women and 83 men) undergoing elective open AAA repair were identified. Seven (7.8%) patients required a postoperative transfusion. Conclusion: This contemporary review suggests elective open AAA repair should continue during an NHSBT amber alert as the risk of transfusion is lower than previously reported.