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Predonated autologous blood use in elective cardiac surgery.
L W Britton1, D T Eastlund, S W Dziuban
1Division of Cardiothoracic Surgery, Albany Medical College, New York 12208.
The Annals of Thoracic Surgery
|April 1, 1989
Summary
Preoperative autologous blood donation effectively reduces homologous blood use in cardiac surgery. While generally safe, some patients, particularly those with coronary artery disease, may experience complications.
Area of Science:
- Cardiovascular Surgery
- Transfusion Medicine
- Anesthesiology
Background:
- Homologous blood transfusions carry documented risks, heightened by acquired immunodeficiency syndrome.
- Preoperative autologous donation (PAD) is a strategy to mitigate these transfusion-related risks.
Purpose of the Study:
- To evaluate the efficacy and safety of PAD in reducing homologous blood requirements for elective cardiac operations.
Main Methods:
- A comparative study of 104 adult patients undergoing elective cardiac surgery with PAD (group 1) versus 111 patients without PAD (group 2).
- Patient demographics, cardiac conditions, donation details, complications, and homologous blood product usage were analyzed.
Main Results:
- Group 1 patients (mean age 58.9) received significantly less homologous fresh frozen plasma (0.1 vs 0.97 units) and packed red blood cells (0.6 vs 2.1 units) compared to group 2 (mean age 67.8).
- 75.5% of group 1 patients required no homologous blood products, versus 21% in group 2.
- The most common complication in group 1 was increasing angina (12.2%), necessitating hospitalization in two cases, particularly in patients with coronary artery disease.
Conclusions:
- Preoperative autologous blood donation is an effective and safe method for reducing homologous blood use in elective cardiac surgery.
- PAD carries some risks, notably for patients with pre-existing coronary artery disease.