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Safety and efficacy of autologous blood donation before elective aortic valve operation
W H Dzik1, A G Fleisher, D Ciavarella
1Department of Pathology, New England Deaconess Hospital, Boston, Massachusetts 02215.
Insights
Preoperative autologous blood donation is safe and effective for patients undergoing elective aortic valve replacement. This approach significantly reduces the need for homologous blood transfusions, improving patient outcomes.
Area of Science:
- Cardiology
- Transfusion Medicine
Background:
- Preoperative autologous blood donation (PABD) is increasingly common for elective surgeries.
- Traditionally, patients needing aortic valve replacement (AVR) were excluded from PABD programs.
Purpose of the Study:
- To evaluate the safety and efficacy of PABD in patients undergoing elective AVR.
- To determine the impact of PABD on homologous blood transfusion rates in AVR patients.
Main Methods:
- Seventy-nine patients undergoing elective AVR donated 1-3 units of autologous blood preoperatively.
- A control group of 298 AVR patients did not undergo PABD.
- Homologous blood exposure rates were compared between the two groups.
Main Results:
- One patient experienced a syncopal episode post-donation, recovering without complications.
- 68% of patients who donated autologous blood avoided homologous transfusions.
- Only 31% of the control group avoided homologous transfusions (p < 0.0001).
Conclusions:
- PABD is a safe and effective option for patients awaiting elective AVR.
- Routine exclusion of AVR patients from PABD programs is not warranted.
- PABD significantly reduces homologous blood use in AVR patients.
Abstract:
Although the use of preoperative autologous blood donations for patients undergoing elective cardiac operations has increased dramatically in recent years, patients awaiting elective aortic valve replacement have traditionally been denied access to preoperative autologous blood collection programs. We report our experience with 79 patients, each of whom donated 1 to 3 units of autologous blood before an aortic valve operation. All patients had serious aortic valve disease as evidenced by symptoms and preoperative catheterization data. The patients collectively made 129 blood donations. One patient had a syncopal episode within 2 hours of donation and recovered without difficulty. Of the patients who gave autologous blood preoperatively, 68% avoided any homologous blood donor exposure during their subsequent hospitalization for aortic valve replacement. In contrast, in a group of 298 patients who did not give autologous blood preoperatively, only 31% avoided homologous blood exposure during aortic valve replacement (p < 0.0001). Our experience suggests that preoperative autologous blood donation by patients awaiting elective aortic valve replacement is both safe and effective. Patients with aortic valve disease should not be routinely excluded from preoperative blood services.