Utilization of preoperative autologous blood donation in elective surgery

The aim of the present paper was to review the pattern of collection and transfusion of autologous red cells for elective surgical procedures

Data on requests for preoperative autologous donation of blood were obtained from the Australian Red Cross Blood Service, Victoria and the Royal Melbourne Hospital for the calendar year 1998. The following information was collected: patient age, sex, surgery type, number of autologous units requested and collected and, if relevant, reasons for not achieving the requested collection. Transfusion of autologous units and any additional homologous units was confirmed from records at the blood banks of the Royal Melbourne Hospital and Melbourne Pathology (the pathology provider performing cross-matching for the majority of autologous units collected by Australian Red Cross Blood Service, Victoria).

Over 12 months, 2803 units of autologous blood were requested and 2282 units collected from 1301 patients. The most common reason for failure to collect the number of units requested was insufficient time between referral and surgery. Of the autologous units collected, 73% were transfused giving a collection to transfusion ratio of 1.4. Sixty-eight per cent of patients received their autologous units only, 10% received both autologous and homologous units, while 22% were not transfused. For the majority of procedures, patients using preoperative autologous donation of blood had higher transfusion rates than those who did not use this.

Ninety per cent of patients undergoing preoperative autologous donation of blood successfully avoided homologous blood exposure. However, preoperative autologous donation of blood is both wasteful and increases the incidence of transfusion in surgical procedures.