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Clinical Terms

"Optimization of presurgical patients can be a complex process. For many surgeons and anesthesiologists, allogeneic transfusion is a simpler solution to any preexisting anemia or coagulation dysfunction. However, given the choice for themselves or one of their family members, many surgeons or anesthesiologists would likely choose the route of optimization.”

— Blood Management: Options for Better Patient Care —AABB and the Society for the Advancement of Blood Management, page 183

We encourage patients to have ongoing discussions with their physicians and with officials at the SRHS Bloodless Medicine and Patient Blood Management Program

Definitions

These procedures are based on similar equipment, with small differences.

Ongoing medical procedures that involve the use of a patient’s own blood include:

  • Hemodilution — Some of the patient’s blood is diverted and replaced with a blood expander, so fewer red cells are lost in surgery. This is advantageous, because it preserves whole blood, including clotting factors.  If the patient becomes unstable at any time during the surgery, the diverted blood is directed back into the patient.
  • Cell salvage — This is often referred to as cell saver, because it reduces blood loss. Blood is suctioned into a filter, and then is washed with saline solution and the red cells are given back to the patient.
  • Dialysis — This acts as an artificial kidney. Blood is run through circuits enabling blood to be washed with saline solution and returned to the patient.
  • Heart-Lung By-pass — Maintains circulation so oxygen can be preserved throughout the body when the heart is stopped for heart surgery.
  • Autologous Platelet Gel — Autologous means “made from you.” Blood is withdrawn from the patient, like in a blood test, and is spun down to provide a platelet-rich solution. The platelets are added to medical glue, such as thrombin, and used as a topical spray over a wound, bone or surgical site to help prevent blood loss and aid in healing. 

Fractions Derived from Blood

Some blood fractions have been used in medicines for decades.  They have been washed with detergent or heat-treated and added to a solution, such as saline solution.  (See also Cohn Cold Fractionation Process) They contain no DNA.  Some examples are:

  • Albumin — A protein isolated from blood to form a blood expander.  Albumin is used in many medications as a stabilizer.
  • Erythropoietin (EPO) — A hormone that stimulates bone marrow to make red cells quicker.  Many of these formulations contain albumin.
  • Clotting Factors — Can be in the form of the medical glue that your surgeon uses in surgery.  Factors such as VII, VIII, IX and X are used to help clot the blood.
  • Immunoglobulins — A protein that forms the base of many vaccines, such as tetanus, measles, mumps, rubella, anti-snake venom and rabies, are examples of immunoglobulins.  Some immunoglobulins drugs help fight infection or cancer.
  • Cryoprecipitate (Cryo) — Make this active: Fresh plasma is frozen, then thawed and spun through a centrifuge to separate a substance called cryoprecipitate. A very small fraction is derived from plasma, and it is used to help clot blood. The FDA approved a substitute for this fraction.  It has not been heat-treated or washed with detergent.  It looks like diluted glue or flour and water.  It forms an invisible net in the blood for your platelets to stick to so a clot will be stabilized. This does not come from the pharmacy. Although it does not require cross and type match, it has to be stored in our blood bank. Cryo contains Factor VIII and Von Willebrand disease. Cryo is a very concentrated form of fibrinogen and is used in numerous disease states including massive bleeding.

Hemoglobin Based Oxygen Carriers and Hemin are not available in the United States
(Source AABB and Dailey’s Notes on Blood)

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