PREOPERATIVE AUTOLOGOUS BLOOD DONATION AN D ITS EFFECTS ON PULMONARY LOBECTOMIES

The aim of our study was to determine the value of preoperative autolo gous blood donation and its importance with regard to pulmonary lobect omies. Over the course of three years and a total number of 22-degrees operations, autologous blood was preoperatively deposited in 74 cases . 21 patients did not meet the criteria for autologous blood donation and were excluded from the study. It was found that only 6.8% of the p atients who had donated autologous blood required a homologous blood t ransfusion versus 27.2% in the non-donor group. This would imply, that the necessity for homologous blood transfusion is reduced by approxim ately 75% in patients depositing autologous blood prior to surgery. Wh ile we observed similar haemoglobin levels in both groups at admission , it was found that autologous blood donors went into surgery with an Hb 1.5 g% lower than non donors; the levels however adjusted themselve s immediately postoperatively. No increased complication rate was foun d as a result of preooperative autologous blood donation. The data ind icate that only 30% of patients undergoing pulmonary lobectomy require homologous blood transfusions. 80% of these patients could benefit fr om preoperative autologous blood donatin. For 70% of all patients the procedure would be of no benefit. Bearing in mind the immunosuppressiv e effect of homologous blood donation a justifiable procedure even und er these circumstances. It would however be beneficial if studies were conducted to investigate to what extent similar results could be achi eved by preoperative acute isovolemic hemodilution.