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Preoperative autologous blood donations in pediatric cardiac surgery
1Department of Cardiovascular Surgery and Blood Transfusion Service, Kyushu University Hospital, Kyushu University, Fukuoka, Japan.
Insights
Preoperative autologous blood donation is safe and effective for children undergoing cardiac surgery. This method significantly reduces the need for homologous blood transfusions in pediatric cardiac operations.
Area of Science:
- Pediatric Cardiac Surgery
- Transfusion Medicine
- Blood Conservation
Background:
- Preoperative autologous blood donation (PABD) is a key strategy to prevent homologous blood transfusions in cardiac surgery.
- Limited data exists on the safety and efficacy of PABD specifically in pediatric populations.
Purpose of the Study:
- To evaluate the safety and efficacy of PABD in children undergoing cardiac operations.
- To assess the feasibility of a blood conservation program involving PABD in pediatric patients.
Main Methods:
- A blood conservation program including PABD was implemented in 1986 for pediatric patients.
- Eighty children (as young as 3 years) donated blood preoperatively (average 735 mL over 3.1 phlebotomies).
- Donated blood was stored via cryopreservation (76%) or liquid storage (24%).
Main Results:
- Only two mild vasovagal reactions occurred during phlebotomy.
- 97.5% of patients underwent cardiopulmonary bypass.
- 94% of patients successfully avoided homologous blood transfusion; 2 received platelet concentrate.
Conclusions:
- PABD is a safe and effective method for pediatric cardiac surgery.
- This approach significantly minimizes the requirement for allogeneic blood products.
- The findings support the routine use of PABD in pediatric cardiac surgical programs.
Background:
Preoperative autologous blood donation is one of the most effective methods to avoid homologous blood transfusion in cardiac operations. However, there have been few reports about the safety and efficacy of autologous blood donation in children.
Methods:
Since 1986, we have instituted a blood conservation program including preoperative autologous blood donations in children. Eighty children as young as 3 years old (mean +/- SD, 8.6 +/- 3.9 years) and weighing as little as 12.3 kg (29.2 +/- 14.5 kg) were enrolled in the program, and 735 +/- 388 mL of blood was donated during an average of 3.1 +/- 1.5 phlebotomies before the operations.
Results:
Two episodes of mild vasovagal reaction were observed in 2 patients as a complication of the phlebotomy. Seventy-six percent of the collected blood was stored by cryopreservation; the remaining 24% was preserved by liquid storage. Seventy-eight of these patients (97.5%) underwent operations using cardiopulmonary bypass. Seventy-five patients (94%) were operated on successfully without the need for a homologous blood transfusion. As for the other 5 patients, 2 received only platelet concentrate.
Conclusion:
Preoperative autologous blood donation is a safe and effective method to avoid homologous blood transfusion in pediatric cardiac operations.