Autologous blood donation for cardiac surgery: Experience with 671 patients
Abstract
Purpose: To determine the effectiveness of autologous blood donation as a blood conservation strategy in a large number of patients undergoing elective cardiac surgery. Methods: Between May 1993 and May 1996, six hundred and seventy one patients underwent autologous blood donation (ABD) prior to cardiac surgery (83% CABG, 12% valve and 5% other). The mean age of the patients was 60±10 years and 82% were males. Results: The patients donated 2,214 units of blood (3.3±0.8 units per patient). Forty six (7%) patients had worsening of symptoms during the donation period. Hemoglobin before and after donations were 143±23 grams/L and 123±21 grams/L. Hemoglobin at 24 hours after surgery was 92±18 grams/L and 106±22 grams/L at hospital discharge. Homologous blood utilization was 0.7±1.8 units per patient and was totally avoided in 80% of the patients. Conclusions: Autologous blood donation is an extremely effective strategy of blood conservation for cardiac surgery. ABD is safe for elective cardiac surgery patients and results in low homologous blood exposure. Clinical Implications: It is an alternative to costly pharmacologic interventions.