INTRAOPERATIVE PREDONATION CONTRIBUTES TO BLOOD SAVING

The merits of reinfusing prebypass-removed autologous blood (intraoper ative predonation) to salvage blood and improve postoperative hemostas is are still debated, specifically for patients at a higher risk for b leeding. To evaluate the effect of intraoperative predonation on the p latelet count, blood hemoglobin content, and blood saving postoperativ ely, we retrospectively studied 100 matching patients. All patients un derwent internal mammary artery, bypass surgery resulting in a conside rable blood loss postoperatively. Intraoperative predonation (800 ml), reinfusion of the residual volume of the extracorporeal circuit, auto transfusion of shed blood, and acceptance of normovolemic anemia posto peratively was the approach adopted in 50 patients (group 1). A simila r blood salvage program, excluding intraoperative predonation, was car ried out in the other 50 patients (group 2), and these served as the c ontrol group. The platelet counts and blood hemoglobin content were si gnificantly higher postoperatively (p < 0.01) in the predonated patien ts than in the control patients. However, the net blood loss, the amou nt of retransfused shed blood, and the blood requirements postoperativ ely were significantly less (p < 0.01) in the predonated patients than in' the control patients, whereas 65% of the predonated patients vers us 10% of the control patients did not need any donor blood products. In conclusion, predonation reduces the postoperative blood loss and th ereby importantly ameliorates the blood-saving effect of a blood salva ge program after IMA procedures.