About cell salvage
Cell salvage is a way of collecting blood lost during an operation. The blood is then filtered and can be given back to you later.
It is sometimes called an ‘autologous’ blood transfusion (meaning it is using your own blood).
We may offer you cell salvage when you have a caesarean section:
• if you are at high risk of significant bleeding
• if you have a condition affecting your placenta
• if you have had more than one caesarean section in the past
• if you are anaemic.
It may also be used if unexpected heavy bleeding happens during any caesarean section.
If you are planning to have a caesarean section, ask your hospital doctor or midwife if cell salvage is suitable for you.
Benefits
Cell salvage reduces the need for a blood transfusion from someone else (a donor) but does not always replace it completely.
Avoiding needing donor blood reduces the very small risks associated with blood from a donor.
The NHS website has more information about blood transfusions.
Cell salvage is often acceptable to people who do not wish to have donor blood for reasons such as faith (for example, Jehovah’s Witnesses).
Also, anyone who has received a blood transfusion cannot then donate blood themselves. This is due to infection risk. But you may still be able to donate blood after cell salvage.
Discussion and consent
If you are due to have a planned caesarean section and are at high risk of significant bleeding, your doctor or midwife will discuss cell salvage with you before your operation. You will be able to ask any questions and let us know if you agree to have the cell salvage.
Some women have unexpected heavy bleeding during a caesarean section. If this happens, we may use cell salvage if we think it would be best for you, even if we have not discussed it with you beforehand. If this happens, we will tell you afterwards and you can decide if you want to receive your salvaged blood back as a transfusion.
How cell salvage is done
It is usual to lose blood during an operation, such as a caesarean section. A cell salvage machine can be used to collect this blood. The red blood cells, which carry oxygen, are then separated out and cleaned. These can then be given back to you later, through a small tube into a vein.
Your own red cells will only ever be given back to you. They cannot be used for someone else.
Risks
There are two main concerns about using cell salvage during caesarean section.
Amniotic fluid gets into your blood stream
During cell salvage, there is a risk that the ‘waters’ that surround your baby in the womb (called amniotic fluid) could get into your bloodstream. This could cause you to have an allergic reaction. However, the blood filter is designed to remove amniotic fluid.
Cell salvage has been used in caesarean section for many years and there is no evidence that it causes harm from amniotic fluid entering the mother’s bloodstream. This is also a risk during any childbirth.
Baby’s blood gets into your blood stream
During cell salvage, there is a risk that the baby’s blood can get into your bloodstream. If this happens, you might develop antibodies that can harm a baby in future pregnancies. This is also a risk during any pregnancy and childbirth.
Women with certain blood types (called rhesus negative) are most at risk of developing these antibodies. If this applies to you, we will offer you an injection of a medicine called ‘anti-D’ within three days of you giving birth. This stops you developing the antibodies. The NHS website has more about this.