Frozen preoperative autologous blood donation for heart transplantation at the Mayo Clinic from 1988 to 1999.
BACKGROUND
Preoperative autologous blood donation (PABD) has been used to reduce the need for allogeneic RBC transfusion, decreasing risk and conserving supply. A frozen PABD program for heart transplant patients was instituted at the Mayo Clinic in 1988, but participation has steadily declined. The aims of this study were to determine how the availability of PABD influenced the transfusion RBC components, whether the availability of PABD reduced exposure to allogeneic RBC components, and the costs of providing PABD units.


METHODS
A retrospective review of all heart transplant cases from 1988 to 1999 was performed (n = 141). Data on collection and transfusion practices were compared for patients with (n = 88, 62%) and without PABD (n = 53, 38%).


RESULTS
Total RBC transfusion requirements did not differ between the groups. Patients with frozen PABD received fewer allogeneic units, but they also had less blood salvaged and reinfused. Twenty patients (23%) completely avoided exposure to allogeneic RBCs in the PABD group versus three patients (6%) in the group without PABD. Although patients in the PABD group successfully donated a total of 423 units, 41 percent were discarded. Over 11 years, the need for 251 units of allogeneic RBCs was avoided ($27,610), but $283,500 was spent to have the frozen PABD units available.


CONCLUSIONS
PABD can be performed for heart transplantation, but it is expensive.
Fontaine
Magali J
MJ
Department of Laboratory Medicine and Pathology, Division of Transfusion Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Winters
Jeffrey L
JL
Moore
S Breanndan
SB
McGregor
Christopher G A
CG
Santrach
Paula J
PJ
D001793:Blood Preservation; D001804:Blood Transfusion, Autologous / Q000191:economics / Q000706:statistics & numerical data; D003365:Costs and Cost Analysis; D015925:Cryopreservation; D017707:Erythrocyte Transfusion / Q000191:economics; D016027:Heart Transplantation / Q000379:methods*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D011300:Preoperative Care; D012189:Retrospective Studies
D006454:Hemoglobins