Preoperative autologous blood donation for bone marrow harvests: are we wasting donors' time and blood?
Predeposit autologous blood donation (PAD) is frequently offered to bone marrow donors, but its cost-effectiveness is dubious. We assessed the impact of PAD and bone marrow donation on transfusion requirements; and the use of donated blood units in a retrospective study of 61 bone marrow donors. The mean haemoglobin (Hb) concentration fell from 12.9 to 11.8 g dL(-1) in women who predonated one unit and from 13.2 to 10.9 g dL(-1) in those who predonated two units. In men who donated two units of blood, the Hb concentration decreased to 12.9 g dL(-1). Bone marrow harvest led to a further decline in Hb concentration by 2.3 g dL(-1) in women and by 2.4 g dL(-1) in men. The postharvest Hb fell to <or=9.0 g dL(-1) in 39% of female and in 6% of the male donors; all but one of them had predonated blood. The utilization rate of autologous units was 45.6%, with 55% of women and 24% of men receiving autologous blood. In females, 59% of transfused autologous units were given with the donor's Hb of >or= 9.0 g dL(-1); overtransfusion was even more apparent in men: 71% units were given with a Hb >or= 10.0 g dL(-1). PAD in bone marrow donors is associated with high wastage and increases the likelihood of requiring a transfusion. We recommend that PAD should not be routinely offered to bone marrow donors.
King's College Hospital, London, UK. aleksandar.mijovic@kingsch.nhs.uk
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Mijovic
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Britten
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Regan
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Harrison
D001804:Blood Transfusion, Autologous; D016026:Bone Marrow Transplantation / Q000379:methods*; D003362:Cost-Benefit Analysis; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012737:Sex Factors; D014019:Tissue Donors
D006454:Hemoglobins