Autotransfusion, also known as cell saver, has become the preferred alternative to allogeneic blood transfusion for a growing number of reasons, especially its capacity to dramatically reduce the need for donor blood. Cell saver technology allows patients to receive their own blood back during a planned procedure or trauma situation, decreasing the risk of infection, disease transmission, and complications. Additionally, autotransfusion has the ability to improve outcomes while remaining less expensive than allogeneic blood transfusion.

The Effectiveness of Autotransfusion

Research shows that cell saver autotransfusion is an effective, safe replacement for allogeneic blood transfusions:

• The Cochrane Database of Systematic Reviews reports that across 75 studies covering orthopedic, cardiac, and vascular procedures, autotransfusion reduced the need for donor blood. Moreover, it did not contribute to any adverse clinical outcomes.
• The American Journal of Translational Research revealed that in a direct comparison with allogeneic blood transfusion, autotransfusion “can better improve the immune status of patients and improve their quality of life.”
• In a study on women undergoing C-section, BMC Pregnancy and Childbirth indicated that the patients who received autotransfusion experienced more benefits than those who received donor blood, such as lower rates of infection, allergies, and adverse cardiovascular events. They also had a significantly shorter length of stay.

The Benefits of Autotransfusion

Autotransfusion has a host of benefits, both clinical and financial, that make it an appealing option for hospitals and ASCs, from the OR to the ER:

• Readily Available. When a patient needs blood urgently, cell saver technology can wash, filter, and restore their blood, improving the chance of positive outcome. Banked blood requires advanced planning – type and screen, crossmatch, and inventory management. Once the banked blood inventory is used, it’s gone. ATS recycles the patient’s lost blood and can continue processing until the need is over. 
• Improved Oxygen Transfer. Autotransfusion reduces excess free hemoglobin, helping the immune system and kidneys; donor blood can lose oxygen and fluidity over time, causing depressed respiratory function.
• More Cost-Effective. The cost burden of recruiting donors as well as acquiring, transporting, storing, and typing blood can be significant. Statista reports that in 2023, the median price at which US hospitals purchased a single unit of leukoreduced RBC blood was $226; this amount does not reflect the cost of storage and transport expenses, how much patients would ultimately be charged for a transfusion, or the cost of unused units that expire and are thrown out. The Red Cross says that an average of three units of blood are needed per transfusion; it also states that one car accident victim alone may require up to 100 units of blood. Because it reduces the need for donor blood, autotransfusion can potentially save thousands of dollars per incident.
• Better Viability. Autologous blood is either used immediately or only stored temporarily for procedures. Its freshness translates into better viability than donor blood, which is only viable for 42 days (or less). Banked allogeneic blood is known to deteriorate the longer it is stored, developing storage lesions that raise potassium levels, deplete 2,3‑DPG, and reduce red cell deformability. By 21 days, potassium in some stored units can reach 30–50+ mEq/L. 2,3‑DPG levels fall to near zero within the first 10 days, limiting the red cells’ ability to unload oxygen to tissues. ATP declines, cell shape becomes distorted, and hemolysis releases free hemoglobin, iron, and inflammatory mediators. Stored blood can also contribute to an acidotic environment due to lactate accumulation.

In contrast, autotransfusion (ATS) blood avoids cold storage entirely. It has potassium levels typically below 5 mEq/L, retains normal 2,3‑DPG (preserving oxygen delivery), and contains none of the inflammatory byproducts associated with storage, such as free hemoglobin, cytokines, or microparticles.

Get Support for Autotransfusion at Your Hospital or ASC

If you’re ready to ramp up autotransfusion services at your hospital or ASC, SpecialtyCare can help. We can place high quality autotransfusion technicians at your location who will fully integrate with your OR and ER teams. We follow all AABB standards and offer a wealth of experience for serving patients with cell saver technology. Whether your patients are undergoing planned procedures, are hesitant about receiving donor blood, or need emergency transfusion care, our team seamlessly works with yours to improve outcomes and reduce length of stay. Contact us today to learn more!