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Feasibility and success of a single-donor red cell program for pediatric elective surgery patients
R G Strauss1, M R Wieland, M J Randels
1Department of Pathology, University of Iowa College of Medicine, Iowa City.
Insights
Limiting exposure to multiple blood donors is beneficial. A single-donor program successfully provided all red blood cells for most pediatric elective surgery patients ineligible for autologous donation.
Area of Science:
- Transfusion Medicine
- Pediatric Surgery
Background:
- Allogeneic blood transfusions carry small risks, necessitating strategies to minimize donor exposure.
- Autologous blood donation is not feasible for all patients, particularly children undergoing elective surgery.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of a single-donor program for red blood cell (RBC) provision in pediatric elective surgery patients.
- To reduce exposure to multiple donors for patients ineligible for autologous blood donation.
Main Methods:
- A program was implemented where one donor provided all RBC units for each patient.
- Seventy-three pediatric patients and 115 potential donors (primarily parents) were enrolled.
- Donor eligibility and completion of RBC donations were tracked, along with patient transfusion outcomes.
Main Results:
- Ninety donors (78%) were eligible, with 21 deemed ineligible due to RBC incompatibility.
- Fifty-eight donors (79%) completed all ordered RBC donations.
- Forty-six patients (63%) received transfusions, with 38 (83%) receiving exclusively single-donor RBCs.
Conclusions:
- A single-donor blood program effectively met the RBC needs for the majority of pediatric elective surgery patients.
- This approach significantly limits donor exposure for patients who cannot utilize autologous blood donation.
- Single-donor programs are a viable consideration for elective surgery patients at risk of multiple donor exposure.
Abstract:
Although the risks of allogeneic blood transfusions are small, it is wise to limit donor exposure whenever possible. A program has been developed in which one donor provided all red cell (RBC) units for each patient awaiting elective surgery. Patients were mostly children who were ineligible for autologous blood donation. Seventy-three patients and 115 donors (mostly parents) entered the program. Of the 115 donors, 90 (78%) were eligible to participate and 25 (22%) were ineligible; 21 were ineligible because of RBC incompatibility. For each of the 73 patients, one eligible donor was selected to donate all RBC units. Preoperative RBC orders were 1 to 2 units for 41 patients and > or = 3 units for 32 patients. Of the 73 donors, 58 (79%) gave all RBC units ordered; 15 (21%) failed to complete all donations, but only 1 because of anemia (hematocrit < 33% [0.33]). Of 73 patients entered, 46 (63%) underwent transfusion, and 27 (37%) did not. Of 46 patients transfused, 38 (83%) received only single-donor RBCs. Thus, the RBC needs of nearly all pediatric elective surgery patients were provided by a single donor for each patient. Single-donor blood programs should be considered for elective surgery patients who are ineligible for autologous blood donation and who would otherwise be exposed to multiple donors.
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