Preoperative red cell production in patients undergoing weekly autologous blood donation

Modest autologous blood donation programs involving weekly phlebotomy and threshold hematocrits for blood donation higher than 33 percent are frequently used in patients scheduled for elective cardiac surgery. This study was performed to determine the gain in red cells (RBCs) obtained with such a program.

The blood bank and medical records of 225 adult patients (194 men, 31 women; mean age, 57 years [range, 18-77]) who donated blood for autologous use in elective cardiac surgery during a 3-year period were reviewed. Preoperative RBC production was estimated by the total volume of RBCs donated minus the change in circulating RBC volume between the first donation and the day before surgery.

A total of 604 blood units were donated (2.7 units/patient; range, 1-3). The mean volume of RBCs donated was 522 mL (range, 171-732). Mean RBC production (over baseline RBC production) was 351 mL (range, 9-719), or 19 percent (range, 0.5-40) of the circulating RBC volume at baseline.

A modest autologous blood donation program using three phlebotomies at weekly intervals and a threshold hematocrit for blood donation of 36 percent yields an average of 351 mL (range, 9-719) of RBCs. This is equivalent to 2 units (range, 0.5-4) of allogeneic packed RBCs at 180 mL per unit.