SP4.5 - Cost estimates of intra-operative cell salvage in patients undergoing major liver surgery: a retrospective cohort study

Abstract Aims Major liver surgery is associated with a high risk of blood loss. Autologous transfusion of blood salvaged intra-operatively (cell salvage) reduces the requirement for post-operative allogenic transfusion. Allogenic transfusion is associated with risks, and blood is a scarce and costly resource. However, the cost of cell salvage in liver resection has not been previously estimated. Objective To estimate the cost of cell salvage in patients undergoing major liver surgery. Methods We analysed a cohort of 243 patients who underwent major liver surgery between 2015 and 2022 at a large tertiary referral hospital in England. Cost of cell salvage was calculated as an average price for consumables and operator time. Cost of admission including cell salvage was assessed per year. Results The average cost of cell salvage per patient was £433. On average, consumables costed £240 and costs associated with operating cell salvage machinery were £193. The average cost for an index admission for this cohort of patients undergoing major liver surgery with cell salvage was £24,694. When comparing the required units of allogeneic blood required to replace the red cells lost during surgery, cell salvage led to cost-savings in one of the years under analysis. Conclusions Our findings suggest that cell salvage has the potential to be cost-effective in patients undergoing major liver surgery. These findings should be assessed in an economic evaluation conducted alongside a randomised controlled trial.