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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2005 October;18(5):283-6
Autologous blood donation before elective cardiac procedure
Yoda M., Shimakura T
Aim. The risk of homologous blood transfusion are well documented and recently increased with the emergence of acquired immunodeficiency syndrome. The purpose of this study was to ascertain how many volume of predonated autologous blood need to avoid of homologous blood transfusion in cardiovascular procedure.
Methods. 128 patients underwent scheduled cardiovascular procedure. These patients had donated without donation 400 ml (mean 242.4 mL, group 1, n=33) or 800 mL (group 2, n=23) of autologous blood. Seventy-two patients operated with CPB, had donated 800ml (group 3, n=36) or 1200 mL (group 4, n=36). Surgical procedures underwent only off pump coronary artery bypass grafting in groups 1 and 2. In groups 3 and 4 included on pump CABG, valve replacement, CABG + valve replacement and atrial septal defect.
Results. There were no significant differences in mean body weight, mean preoperative hematocrit values or mean volume of intraoperative blood loss between groups 1 and 2. There were no significant differences in mean age, mean body weight, mean preoperative and postoperative day (7) hematocrit values, mean volume of intraoperative blood loss or mean CPB time between groups 3 and 4. The mean postoperative day (7) hematocrit value was significantly lower in group 1 than in group 2. Homologous blood transfusion was avoided in 63.6% of those with predonation of group 1 versus 100% at group 2 (p<0.05), 86.1% at group 3 versus 94.4% at group 4 (p<0.05).
Conclusions. Autologous blood transfusion is effective for reducing the homologous blood requirement. We believe that 800ml predonation is sufficient to avoid homologous blood transfusion in elective cardiac surgery, further 1200 mL predonation is desirable in cases of redo operation or CABG + valve replacement.