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Haemolysis is the process by which red blood cells are broken open and their contents, haemoglobin, is spilled out into the surrounding blood or tissue. When this happens within the body it is called in vivo haemolysis. This can be caused by certain blood cell disorders such as anaemia or leukaemia, or by getting injured through accidents or as a by-product of surgery. When haemolysis happens outside the body it is known as in vitro haemolysis. This is usually caused when blood is taken for testing and damage occurs to the cells which results in their breaking open and spilling out their contents. Sometimes, if a great deal of blood loss is anticipated during a major surgery, such as a heart operation, a machine is used to filter the blood out of the body, clean it, then return it to minimise blood loss. Haemolysis can occur during this procedure if the blood machine is not carefully monitored.