The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on intraoperative red blood cell salvage during radical prostatectomy or radical cystectomy.
NICE considered the evidence relating to the efficacy and safety of intraoperative blood cell salvage in obstetrics (IPG144) and for intraoperative red blood cell salvage during radical prostatectomy or radical cystectomy (IPG258) in response to concerns expressed about theoretical risks associated with the procedure. These concerns were the possibility of amniotic fluid embolism and haemolytic disease in future pregnancies when used in obstetrics, and reinfusion of malignant cells when used in radical prostatectomy/cystectomy.
The evidence relating to safety of cell salvage in these procedures was considered adequate and therefore NICE does not intend to review its use in other specific clinical situations unless notified of new indications for intraoperative cell salvage in which there may be new safety concerns.
Intraoperative blood cell salvage involves the collection of the solid components of the blood lost during an operation which is then transfused back to the same patient.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.