Utilization and efficacy of autologous blood predeposit in radical prostatectomy with lymphadenectomy: implications for blood conservation and physician education programs.
Autologous blood predeposit is a widely used transfusion practice that has become a standard of care for elective surgery. Despite the support for this practice there are unanswered questions in the usage and efficacy of autologous blood programs. This study is a prospective analysis of 52 consecutively audited urologic patients undergoing elective, radical prostatectomy with lymphadenectomy in which all 52 patients predonated autologous blood. Preoperative blood donation, blood transfused, surgical blood lost, and the "transfusion trigger" were evaluated for each of these patients. We conclude (1) the rate of homologous blood exposure (15%) despite preoperative autologous blood donation in every patient indicates a need for innovative blood conservation strategies to minimize homologous blood transfusion in this surgical group. (2) Unnecessary autologous transfusions could be identified in 8 (15%) of 52 patients, all of which were single unit autologous blood transfusions. (3) Physician education programs that emphasize increased procurement of autologous blood along with more conservative transfusion of this blood are needed to avoid necessary homologous blood and unnecessary autologous blood transfusion.
Goodnough
L T
LT
Department of Medicine, Case Western Reserve University, Cleveland, Ohio.
Riddell
J
J
Kursh
E
E
Resnick
M I
MI
D001793:Blood Preservation; D001804:Blood Transfusion, Autologous / Q000706:statistics & numerical data*; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D011300:Preoperative Care; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods