ORIGINAL RESEARCH article
Front. Physiol.
Sec. Renal Physiology and Pathophysiology
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1640701
The effects of transfusion load on renal function in intraoperative salvage autotransfusion: a retrospective cohort study for 200 patients
Provisionally accepted
Honglan Wang1Meixin Zhang1Yu Gu2Weixin Zeng1Mei You1Wenxing Chen1,3Zhongshu Wu1Yahua Ye1Weitao Yu1Shuxuan Wang4
Jingyang Zeng5*- 1Fujian Medical University Affiliated First Quanzhou Hospital, Quanzhou, China
- 2The Fourth People’s Hospital of Zigong, Zigong, China
- 3First Affiliated Hospital of Fujian Medical University Department of Neurology, Fuzhou, China
- 4Graduate School of Fujian Medical University, Fuzhou, China
- 5Department of Pediatrics, Quanzhou First Hospital, Fujian Medical University, Quanzhou, China
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Objectives: This study aimed to investigate the effect of transfusion load on renal function during intraoperative salvage auto-transfusion. Methods: A total of 200 patients were assigned to five groups based on the transfusion load: 0-200 ml (Group A, n=40), 201-400 ml (Group B, n=40), 401-600 ml (Group C, n=40), 601-800 ml (Group D, n=40), >800 ml (Group E, n=40). Serum creatinine (sCr) and free hemoglobin (FHb) concentrations were measured at preoperative baseline (T0), 1 hour (T3), 2 hours (T4), 12 hours (T5), and 24 hours (T6) post-auto-transfusion. FHb and sCr levels were also assessed in the blood storage tank before washed (T1) and in the reinfusion bag after washing (T2). Results: In Groups A, B, and C, there was no significant change in sCr levels between T0 and subsequent time points (T3, T4, T5, T6). However, in Groups D and E, sCr levels increased by more than 26.5 μmol/L from baseline at T3 and T4, with sustained elevations at T3, T4, and T5 compared to T0. FHb concentrations were higher in both T1 and T2 compared to T0, following a similar trend as sCr. Patients receiving more than 600 ml of autologous transfusion showed a transient increase in sCr at 1 and 2 hours post-transfusion, consistent with acute kidney injury (AKI), which resolved by 24 hours after transfusion. Conclusion: Attention should be paid to renal function in patients receiving large volumes (>600 ml) of salvaged blood during intraoperative auto-transfusion, as these patients may experience transient AKI, which resolves over time.
Keywords: Acute Kidney Injury, Creatinine, free hemoglobin, Intraoperative salvage auto-transfusion, Clinical investigation
Received: 04 Jun 2025; Accepted: 28 Aug 2025.
Copyright: © 2025 Wang, Zhang, Gu, Zeng, You, Chen, Wu, Ye, Yu, Wang and Zeng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jingyang Zeng, Department of Pediatrics, Quanzhou First Hospital, Fujian Medical University, Quanzhou, China
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