PREOPERATIVE AUTOLOGOUS BLOOD DONATIONS IN PEDIATRIC CARDIAC-SURGERY

Background. Preoperative autologous blood donation is one of the most effective methods to avoid homologous blood transfusion in cardiac ope rations. However, there have been few reports about the safety and eff icacy of autologous blood donation in children. Methods. Since 1986, w e have instituted a blood conservation program including preoperative autologous blood donations in children. Eighty children as young as 3 years old (mean +/- SD, 8.6 +/- 3.9 years) and weighing as little as 1 2.3 kg (29.2 +/- 14.5 kg) were enrolled in the program, and 735 +/- 38 8 mL, of blood was donated during an average of 3.1 +/- 1.5 phlebotomi es before the operations. Results. Two episodes of mild vasovagal reac tion were observed in 2 patients as a complication of the phlebotomy. Seventy-six percent of the collected blood was stored by cryopreservat ion; the remaining 24% was preserved by liquid storage. Seventy-eight of these patients (97.5%) underwent operations using cardiopulmonary b ypass. Seventy-five patients (94%) were operated on successfully witho ut the need for a homologous blood transfusion. As for the other 5 pat ients, 2 received only platelet concentrate. Conclusion. Preoperative autologous blood donation is a safe and effective method to avoid homo logous blood transfusion in pediatric cardiac operations.