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Springer Intraoperative Autotransfusion: Untersuchungen zur Effektivität und Qualität der Aufarbeitung gewaschener, autologer Erythrozyten: 183 ... and Intensive Care Medicine, 183)

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"Der Tatsache, d~ jede Transfusion fremden Blutes naturgemaE eine ,Fehltransfusion' sein muE, wird im allgemeinen zu wenig Bedeutung beigemessen". Dieser Satz eines namhaften deutschen Trasfusionsme diziners verlangt es, von uns ernst genommen zu werden, denn in der Tat kann trotz Beachtung der ABO-Blutgruppen, der Rhesusgruppen und eventueller Untergruppen das Blut eines Spenders mit dem des Empfangers nahezu nie absolut identisch sein. Dies ist einer der Beweg grtinde, die in der jilngeren Vergangenheit zu einer gewissen Renaissance der intraoperativen Autotransfusion gefiihrt haben. Dariiber hinaus gilt als sicher, d~ durch Blutgaben tibertragbare Infektionskrankheiten wie Transfussionshepatitis, Zytomegalie- und Epstein-Barr-Virus-Erkran kungen sowie die derzeit viel diskutierte Erkrankung AIDS durch Auf arbeitung und Retransfusion des korpereigenen Blutes wenn nicht ganzlich verrnieden, so doch zumindest vermindert werden konnen. Die praoperative Blutentnahme, evtl. in Verbindung mit Tiefkiihl konservierung von Frischplasma und/oder Erythrozyten, die isovolii mische Hamodilution, aber auch erganzende Verfahren, wie z. B. kilnst liche Hypotension sind geeignet, den intraoperativen Fremdblutbedarf zu reduzieren. Solange der Einsatz kilnstlicher sauerstofftransportieren der Losungen noch den Forschern und nicht den Klinikern vorbehal ten bleibt, kann die intraoperative Autotran~fusion als ein sinnvolles alternatives oder erganzendes Verfahren der Fremdbluteinsparung an gesehen werden.

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