COMPARABLE SAFETY OF BLOOD COLLECTION IN HIGH-RISK AUTOLOGOUS DONORS VERSUS NON-HIGH-RISK AUTOLOGOUS AND DIRECTED DONORS IN A HOSPITAL SETTING

The safety of autologous blood donation by ''high-risk'' patients (tho se with some preexisting medical conditions) has been questioned. The authors reviewed 1393 consecutive blood donation records (207 highrisk autologous [HRA], 665 non-high-risk autologous [NHRA], and 521 direct ed donors [DD]) to determine the safety and outcome of blood donation by HRA patients as compared with other donors at their center. The HRA group included patients with a history of significant coronary artery or cerebral vascular disease, recent seizures, cardiac arrhythmia, ch ronic heart failure, valvular or congenital heart disease, symptomatic dyspnea, insulin-dependent diabetes and/or current therapy with two o r more antihypertensive medications. Those designated NHRA were all ot her autologous donors; DD met all criteria for homologous donation. Do nor characteristics including predonation hematocrit, pre- and postdon ation mean arterial pressure and heart rates were similar in all group s. Eight HRA donors (3.9%) had reactions, compared with 21 NHRA (3.2%) and 23 DD (4.4%), a difference that was without statistical significa nce. The reaction rate in all autologous donors (HRA and NHRA) was 3.4 %. No differences in symptoms reported, hemodynamics or reaction sever ity were observed among the three groups (P > .05). A multiple logisti c regression was performed within and among the groups with the risk f actor categories listed above and medication classes including beta bl ockers, cardiac glycosides, calcium-channel blockers, antihypertensive agents, nitrates, and antiarrhythmic agents (X(2) = 14.9; P = .0006). Only first-time donation (P = .0001) and cardiac glycoside usage (P = .04) were positively associated with an untoward reaction. The author s conclude that donation by HRA donors is at least as safe as that by donors who meet homologous donation criteria in their population and s etting.