The development of an optimized autologous blood donation program

Autologous blood (ABD) programs have been in place in Canada since the late 1980s. Activity is decreasing in many sites and utilization averages 50%.

In an effort to optimize our ABD program we introduced one time single donation red cell collection (Trima) with and without erythropoietin and compared the results to those with standard red cell collections. A pre-pilot study assessed feasibility.

To date a total of 59 patients have entered the three arm Trima/epo pilot involving prostate surgery patients: their pre-surgical Hg 158 was compared to 108 in normal autologous control patients. By decreasing the standard pre-donation autologous requirement of three units of red cells to a single Trima collection and at $300 per autologous unit, this represents a cost savings of $36,000 in our 59 patients. When applied to the total autologous program at our hospital (450 per year), this extrapolates to a minimum savings of over $250,000 when using combined collection approaches. 32/59 patients in this pilot study have received only autologous blood, again reducing the number of allogeneic units that would have been required. The need for only a single autologous donation cuts nursing time by 2/3 and also saves laboratory money, since only a single unit is tested for infectious diseases.

When applied to an autologous blood program, the use of the Trima machine combined with erythropoietin in appropriate cases, results in a decrease in the number of units collected and a higher pre-operative hemoglobin. This program should see application in other sites.