Acute normovolemic hemodilution for radical prostatectomy: Can it replace preoperative autologous blood transfusion?

Background: Although preoperative autologous blood donation (PAD) is accept ed as a standard of care for radical prostatectomy, it is costly, time-cons uming and has risks associated with blood storage. Acute normovolemic hemod ilution (ANH) is reported to be less expensive and to preserve blood compon ents more effectively than PAD. In the present study, the efficacy and safe ty of these two autologous blood-collection techniques were compared. Methods: The study included 16 consecutive patients scheduled for radical p rostatectomy. The first eight patients underwent conventional preoperative autologous blood donation of 400 mL 1 week before the operation (PAD group) and the second eight patients underwent acute normovolemic hemodilution fo llowed by immediate operation (ANH group). All blood collected was transfus ed in the perioperative period. Preoperative and postoperative hematocrit l evels in these two groups were compared. Results: There were no differences in preoperative hematocrit, time of oper ation or operative blood loss between the two groups. In the ANH group, 108 0 +/- 160 mL of blood were collected. The postoperative hematocrit level di d not differ significantly between the groups. No patient in either group r eceived allogeneic blood transfusion or experienced an adverse event direct ly related to blood transfusion. Conclusion: The two blood-conservation strategies resulted in similar posto perative hematologic outcomes. Given its advantages, which include lower co st, lower risk and higher convenience, ANH is one of the procedures that ma y replace conventional PAD for use in radical prostatectomy.