Autologous blood donation for surgery in inflammatory bowel disease - a report of six cases

Background: Surgery in inflammatory bowel disease (IBD) is frequently assoc iated with need for perioperative blood transfusions carrying the potential risk of infection. Autologous blood donation is often limited by IBD-assoc iated anemia which is reversible by intravenous iron and erythropoietin. We therefore tested the feasibility of autologous blood donation in IBD. Methods: Six patients (five Crohn's disease, one ulcerative colitis) with i ndication for elective bowel resection were treated after informed consent was obtained. Two to four blood donations were scheduled during four weeks prior to surgery. Once a week 350-450 ml of blood were collected from patie nts with a hemoglobin level above 11.0 g/dl. After each donation 200 mg of iron saccharate diluted in 0.9% saline were given to all patients intraveno usly as substitute for donation-related iron loss. Patients with preexistin g anemia or C-reactive protein above 2.0 mg/dl received concomitant erythro poietin. Results: The scheduled number of packed red cells was donated successfully by four patients. Due to low hemoglobin levels two patients donated one uni t less than intended. Four patients received autologous blood transfusions intra- or post- operatively. No patients needed homologous blood. No seriou s adverse events were observed during blood donations, perioperatively, and during the one year follow-up period. Conclusion: Preoperative autologous blood donation is save and feasible in IBD patients with elective bowel resection.