[Risks and side effects of autologous transfusion]

Area of Science:

• Transfusion Medicine
• Patient Safety
• Surgical Complications

Context:

• Autologous transfusion use is rising, yet risks and side effects remain under-documented.
• Preoperative autologous donations are contraindicated in patients with compromised organ function, though specific thresholds are debated.
• The risk of adverse events, particularly cardiocirculatory, is notably higher in autologous donors compared to homologous recipients.

Purpose:

• To review and highlight the documented and potential risks and side effects associated with various forms of autologous transfusion.
• To critically evaluate the safety parameters and contraindications for preoperative autologous blood donation.
• To assess the quality and safety concerns of blood products obtained through intraoperative autotransfusion and other autologous methods.

Summary:

• Autologous donations, especially when rapid, increase risks like reduced oxygen transport capacity and cardiocirculatory incidents.
• Concerns exist regarding erythropoietin use, quality of intraoperative autotransfused products, and potential immunosuppression from plasma components.
• Bacterial contamination, tumor cells, fat emboli, and activation of coagulation/fibrinolysis are significant risks associated with autologous blood processing.

Impact:

• Highlights the need for improved documentation and understanding of autologous transfusion risks.
• Suggests that current practices may require re-evaluation to mitigate patient harm.
• Emphasizes the necessity for further research and development to enhance the safety and efficacy of autologous transfusion procedures.