HISTORY OF AUTOLOGOUS TRANSFUSION

The early history of autologous transfusion is confined to descriptions of recovery and reinfusion of blood shed by surgical and obstetric patients. Blood salvage was first reported in the American literature in 1917.^[10] By 1936, 277 cases had been reported.^{[11] [12] [13] [14]} Sporadic reports of use of the technique in patients with hemothorax appeared in the surgical literature from 1931^[15] through the early 1970s. However, the technique was used only as a life-saving measure, and little was known about the quality of the product reinfused. In 1966, Symbas^[16] undertook a series of laboratory and clinical studies leading to adoption of an autotransfusion protocol for managing patients with acute traumatic hemothorax that was employed in more than 400 patients between 1966 and 1978.

Reports of instrumentation developed specifically for intraoperative blood recovery, and autologous transfusion began to appear in 1966.^[17] In 1969, investigators reported on the use of a continuous-flow centrifuge bowl that was capable of separating and concentrating erythrocytes in the irrigating fluid returned during transurethral resection of the prostate.^[18] Initial clinical trials were performed in Vietnam and reported in 1970.^[19] Intraoperative blood recovery and reinfusion was demonstrated to be safe and effective in patients sustaining blunt and penetrating trauma to the chest and abdomen and ruptured ectopic pregnancies, as well as in patients undergoing a variety of elective and emergency intra-abdominal operations. A variety of disposable blood collection and reinfusion devices for intraoperative and postoperative blood collection have been introduced since 1976.^[20]