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Thread: UK Bloodless Surgery

  1. #1
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    Smile UK Bloodless Surgery

    Hello all. Thanks for providing a forum such as this for the advancement of bloodless surgery.
    My first post and reason for posting is 2 fold.

    I work at the local hospital as a Ward Manager on an acute colo-rectal Surgical ward, and we were fortunate in that 2 years ago the local congregations of Jehovah's Witnesses donated a blood cell saver machine to the hospital. I was dismayed to learn that due to "cost" this as far as I am aware, has not been utilised in the way that it could have been. Has anyone got any further information on Cell Saver machines and usage of.

    Secondly having a JW background myself (My mother is JW and I was raised in this faith) I would be extremely interested to know of areas in the UK that specialise in Bloodless Surgery......does anyone have a list of co-operating hospitals?

    Thanks again, and good to be here!
    Scott

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  3. #2
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    Try: Dr Ronald Lo
    Consultant Anaesthetist
    Chair, Hospital Transfusion Committee
    North Middlesex University Hospital
    London. N18 1QX

    This Hospital will be receiving a "Cell Saver" this month.

    Glad to be of some help. Brian J Brooks HLC London.

  4. #3
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    Thanks Brian

  5. #4
    jvarisco
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    Scott,
    What "brand" of cell-saver do you have at your facility? When you speak of "cost" I am a little curious as to why the machine is not being utilized more since it appears that the machine was donated. The cost after the initial purchase of a machine is the disposables used for each case. Depending on the brand of cell-saver you have, disposables are usually less expensive then a unit of blood. Could it be possible to do a cost comparison between one use of the cell-saver vs. the cost of 2 units of blood. Present this information to your financial "watch dogs" and see if it would be more cost effective to use the cell-saver machine especially in regards to large blood loss surgeries, i.e. orthopedic, colon-rectal, heart, etc. . .
    That is just cost for cost, not taking into consideration length of stay or adverse complications due to blood transfusion. One reaction or transfer of virus from the blood could escalate the "cost" of patient care considerably.
    Also, the benefit of cell-salvage is that the patient gets back their own blood and it has 100% ability to carry oxygen. Stored blood loses the ability to carry and off load oxygen depending on the length of storage.
    Let us know what you come up with in this regards. Welcome to the site!

  6. #5
    Managing Editor Jan B. Wade's Avatar
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    True Cost

    I agree Jessica. This is a matter of not looking at true costs.

    Since it has been shown that each unit of blood increases length of stay has the cost of that longer stay versus cost of cell salvage been analyzed?

    Each unit of blood causes increased immunosuppression. What is the cost of a secondary infection or recurrance of cancer versus cell salvage?

    The unit is already there. It is taking up space. Perhaps you could put together a focus committee to do a thorough cost analysis for you administrator. You could look for published material showing the true costs of blood and compare that to the cost providing a technician and disposibles for the cell salvage machine.

    We haven't even mentioned the benefits to the patient have we?
    Mr. Jan B. Wade
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  7. #6
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    Hi Scott,
    I am involved in a National Blood Conservation program in South Africa. Two years ago I spent 5 weeks in Southport and was involved in an Joint Replacement Initiative for the NHS. We work quite closely with the Jehovah's Witness Community in South Africa and from what I can remember, the cell saver you recieved is a Fresenius C.A.T.S machine. I have quite a lot of literature on the machine as well as research on studies done. Will be happy to share these with you. Send me an e mail and we can see where I can assist you.
    Regards,
    Mandy Watermeyer
    Netcare Blood Conservation
    Johannesburg
    South Africa
    mwaterm@ho.netcare.co.za

  8. #7
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    Hi Scott - I have read with interest all the comments from our cousins across the pond - all very correct and ship-shape, and it's encouraging to get that kind of help. However, if you contact Dr Lo at North Middx Hospital you will be amazed at the experience he has had in the use of cell savers in UK, also he has a team that makes the running of cell savers cost effective. Please..... contact him. Warm regards. Brian. hlc London.

  9. #8
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    Scott; can I add to this? Another place to contact would be Queens Medical Centre, Nottingham. Dr Jo Lamb, cons anaesthetist, has led a lot of work on cell salvage there. Also, the Trent regional transfusion group have been the driving force behind the new intraoperative cell salvage national competencies which are currently in draft format.

    Alternatively, you could contact the NBS hospital liaison team via your local blood centre (http://www.blood.co.uk) and they will be able to advise on others locally who have similar equipment. Most hospitals now have specialist practitioners of transfusion (SPOT's) who would know who is prepared to practice bloodless surgery in their Trust and local area. Their website is also useful for these type of contacts (http://www.bloodspot.org/).

    Best Rgds,
    Becky Case, Hospital Transfusion Team Manager, Leeds Teaching Hospitals NHS Trust

  10. #9
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    Thanks so much to all for your help and advice. Its much appreciated, and I'll let you know how I get on.
    Scott

  11. #10
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    Hi Scott,
    I am a Transfusion Practitioner and come from a theatre background. I look after the training in my trust for IOCS and we have 3 cell savers. It takes awhile to set the system up but it is very cost effective and the main thing is its so much better for the patient. We have the cell saver 5 if you have any questions get in touch and I will try to help if I can.

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