IMPACT OF AUTOLOGOUS BLOOD PREDONATION ON A COMPREHENSIVE BLOOD CONSERVATION PROGRAM

Preoperative autologous donation has been shown to be a highly effecti ve measure in reducing homologous blood use in cardiac operations. The aim of our study was to verify the effectiveness of this procedure an d to see whether it is compatible with a comprehensive blood conservat ion program. Three hundred forty-eight patients (group 1) donated an a verage of 657 +/- 199 mL of blood before open heart operation, whereas 344 patients (group 2) without autologous predonation were used as a control. The two groups were compared with regard to homologous blood use and the possibility of applying other blood Conservation measures. Homologous transfusion rate in group 1 was 12.6%, whereas in group 2 it was 46% (p < 0.001). Patients with three units of predonated autolo gous blood had a transfusion rate of 0.8% (p < 0.001 compared with gro up 2). In group 1, acute normovolemic hemodilution was accomplished in a lower number of patients and with a lower average withdrawal (338 /- 102 versus 403 +/- 145 mL; p < 0.001). Other blood conservation mea sures such as the return of mediastinal drainage and use of residual b lood of extracorporeal circulation were applied with similar results i n both groups. In our experience, preoperative autologous donation was compatible with the application of other blood conservation measures, but acute normovolemic hemodilution was achieved in a lower number of patients. Preoperative autologous donation proved to be a highly effe ctive method for reducing banked blood use and therefore homologous bl ood exposure during and after cardiac operations.