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The development of an optimized autologous blood donation program
G Rock1, J Bormanis, D Neurath
1Division of Hematology and Transfusion Medicine, Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ottawa, ON, Canada. cag@ca.inter.net
Summary
Optimizing autologous blood (ABD) programs with the Trima machine and erythropoietin (EPO) reduces red cell collections and increases pre-operative hemoglobin. This approach offers significant cost savings and improved efficiency for patient care.
Area of Science:
- Transfusion Medicine
- Surgical Patient Blood Management
Background:
- Autologous blood donation (ABD) programs in Canada, established in the late 1980s, face declining activity and low utilization rates.
- Current ABD programs often require multiple donations, leading to inefficiencies and reduced patient compliance.
Purpose of the Study:
- To optimize autologous blood collection processes by implementing a single-unit red cell collection method using the Trima machine.
- To evaluate the efficacy of combining Trima collection with erythropoietin (EPO) administration in improving pre-operative hemoglobin levels and reducing overall blood unit requirements.
Main Methods:
- A pilot study was conducted involving prostate surgery patients, comparing a single-unit Trima collection (with or without EPO) to standard multi-unit red cell collections.
- Feasibility was assessed through a pre-pilot study, and patient outcomes were compared based on pre-surgical hemoglobin levels and blood unit usage.
Main Results:
- The Trima system, particularly with EPO, significantly increased pre-operative hemoglobin levels (158 g/L) compared to standard autologous controls (108 g/L).
- Reducing the collection requirement from three units to one Trima unit resulted in substantial cost savings (estimated over $250,000 annually for the hospital) and reduced laboratory testing costs.
- A single autologous donation decreased nursing time by two-thirds and allowed 32 out of 59 patients to receive only autologous blood, minimizing allogeneic transfusion needs.
Conclusions:
- The Trima machine, in conjunction with EPO for selected patients, enhances autologous blood programs by decreasing the number of units collected and improving pre-operative hemoglobin.
- This optimized approach offers significant cost-effectiveness, operational efficiencies, and improved patient outcomes, with potential for broader application across healthcare sites.