Autologous blood donation for surgery in inflammatory bowel disease--a report of six cases.
BACKGROUND
Surgery in inflammatory bowel disease (IBD) is frequently associated with need for perioperative blood transfusions carrying the potential risk of infection. Autologous blood donation is often limited by IBD-associated anemia which is reversible by intravenous iron and erythropoietin. We therefore tested the feasibility of autologous blood donation in IBD.


METHODS
Six patients (five Crohn's disease, one ulcerative colitis) with indication for elective bowel resection were treated after informed consent was obtained. Two to four blood donations were scheduled during four weeks prior to surgery. Once a week 350-450 ml of blood were collected from patients with a hemoglobin level above 11.0 g/dl. After each donation 200 mg of iron saccharate diluted in 0.9% saline were given to all patients intravenously as substitute for donation-related iron loss. Patients with preexisting anemia or C-reactive protein above 2.0 mg/dl received concomitant erythropoietin.


RESULTS
The scheduled number of packed red cells was donated successfully by four patients. Due to low hemoglobin levels two patients donated one unit less than intended. Four patients received autologous blood transfusions intra- or postoperatively. No patient needed homologous blood. No serious adverse events were observed during blood donations, perioperatively, and during the one year follow-up period.


CONCLUSIONS
Preoperative autologous blood donation is save and feasible in IBD patients with elective bowel resection.
Mittermaier
C
C
Department of Gastroenterology and Hepatology, General Hospital Vienna, University of Vienna, Austria.
Kurz
M
M
Rosskopf
K
K
Hoecker
P
P
Moeschl
P
P
Gangl
A
A
Gasche
C
C
D000328:Adult; D001804:Blood Transfusion, Autologous; D003093:Colitis, Ulcerative / Q000097:blood / Q000601:surgery*; D003424:Crohn Disease / Q000097:blood / Q000601:surgery*; D017707:Erythrocyte Transfusion; D005240:Feasibility Studies; D005260:Female; D006452:Hemoglobinometry; D006801:Humans; D008297:Male