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.