DEPOSIT OF AUTOLOGOUS BLOOD AT SHORT INTE RVALS

Homologous transfusion is associated with infectious and immunological risks. Preoperative autologous deposit reduces homologous transfusion requirements considerably. Usually donations are carried out at weekl y intervals. In this study we investigated the effect of shorter donat ion intervals on erythropoiesis and perioperative transfusion requirem ents. Methods. A total of 40 consecutive patients scheduled for hip ar throplasty and taking part in an autologous donation programme were ra ndomly assigned to two groups: group I gave blood on days 0, 3, 7 (and 14), group II at weekly intervals. The aim was deposit of three blood units of 450 ml. A patient was deferred if hemoglobin concentration p rior to donation fell below 11 g/dl, and in this case 100 mg Fe 2 + th ree times daily was prescribed. Blood was stored with CPDA-1 anticoagu lant. Surgery was performed between day 28 and 35. A perioperative hem oglobin concentration lower than 9 g/dl was considered a transfusion t rigger. Results. Group I was made up of 21 patients (10 women, 11 men, aged 39-69 years) who gave blood at short intervals, and group II of 19 patients (10 women, 9 men, aged 37-77 years) who gave blood at week ly intervals. General data, calculated blood volume and erythrocyte ma ss prior to donation were comparable. Each patient donated three units . Four patients had to be deferred once, one in group I, three in grou p II. The hemoglobin concentration in group I decreased from 13.9 +/- 1.2 g/dl (x +/- SD) to 13.3 +/- 1.0 g/dl prior the operation, in group II from 13.5 +/- 1.3 g/dl to 12.5 +/- 1.1 g/dl. Preoperativly the hem oglobin concentrations differed significantly (P < 0.05), as did calcu lated erythrocyte mass (1633 versus 1474 ml, P < 0.05). Reticulocytes increased from 46 x 10(3)/mul (median) to a maximum of 94 x 10(3)/mul on day 7 in group I, and from 44 x 10(3)/mul to 10(8) x 10(3)/mul in g roup II on day 14. Serum ferritin decreased from 122 mug/l (median) to 82 mug/l in group I, and from 140 mug/l to 77 mug/l in group II. Thes e parameters did not differ statistically between the two groups. Intr a- and postoperative blood loss amounted to 2175 ml (median) in group I versus 1430 ml in group II (P < 0.05). The perioperative hemoglobin concentration was similar in the two groups. Homologous transfusion re quirements were similar in the two groups (1 unit in group 1, vs 3 uni ts in one patient and I unit in two patients in group II). Conclusions . Short donation intervals resulted in a higher preoperative erythrocy te mass after similar preoperative deposit, and significantly higher b lood loss was tolerated with similar homologous transfusion volume.