Preoperative Autologous Blood Donation Reduces the Need for Allogeneic Blood Products: A Prospective Randomized Study

• Published in: Canadian Journal of Surgery 2008-12, Vol.51 (6), p.422-427
• Main Authors: Bouchard, Denis, MD, Marcheix, Bertrand, MD, Al-Shamary, Sfoug, MD, Eynden, Frédéric Vanden, MD, Demers, Philippe, MD, Robitaille, Danielle, MD, Pellerin, Michel, MD, Perrault, Louis P., MD, Carrier, Michel, MD
• Format: Article
• Language: English
• Subjects: Aged; Aortic valve stenosis; Blood & organ donations; Blood Donors; Blood products; Blood Transfusion; Blood Transfusion, Autologous; Blood transfusions; Cardiac Surgical Procedures; Care and treatment; Female; Health aspects; Heart; Heart Diseases - surgery; Heart surgery; Humans; Male; Middle Aged; Original; Patient outcomes; Preoperative Care; Prospective Studies; Studies; Surgery; Transplantation, Homologous
• ISSN: 0008-428X; 1488-2310
• DOI: 10.1016/S0008-428X(08)50118-4

Objective We sought to assess the efficacy of preoperative autologous blood donation in reducing patient exposure to allogeneic blood products following elective cardiac surgery. Methods We included 48 patients in a prospective study and randomly assigned them into the control or treatment group. We excluded patients with aortic stenosis, main trunk stenosis and unstable angina. Group A ( n = 23; coronary disease n = 21 and valvular disease n = 2) was the control group, and group B ( n = 25; coronary disease n = 21, valvular disease n = 4) received preoperative autologous blood donation. All patients had cardiopulmonary bypass surgery, and we processed mediastinal blood with a cell-saver device before reinfusion. All patients received aprotinin, and we reinfused blood shed from the mediastinum postoperatively. Results No major peri- or postoperative complications occurred. We interrupted preoperative blood donation in 2 patients (8%) because of worsened angina pectoris. The mean time between the first blood donation and surgery was 22.5 (standard deviation [SD] 9.4, range 12–50) days. In group A, 9 patients (39.1%) were exposed to allogeneic blood products. In group B, 11 patients (47.8%) were exposed to blood products ( p = 0.73), and 4 (16%) were exposed to allogeneic blood products ( p = 0.036). Conclusion Preoperative blood donation was completed in 92% of the targeted low-risk population. The procedure significantly reduced exposure to perioperative allogeneic blood products.