[Preoperative autologous blood donation in cardiac surgery. Reduction of allogeneic blood requirements].
BACKGROUND
Preoperative autologous blood donation is an effective method to reduce allogeneic transfusion requirement. However, this method is only rarely utilized in cardiac surgery. Besides economic concerns one essential argument against predonation is the lack of sufficient time due to the short waiting lists. The aim of the present study was to investigate the efficacy of autologous predonation to reduce allogeneic blood transfusion in routine cardiac surgery on a center without longer preoperative waiting lists.


METHODS
A total of 2,626 cardiac surgery patients were included. Primary endpoint of the study was the perioperative incidence of allogeneic packed cell transfusion. If time between diagnosis and admission to the hospital was >10 days, predonation was offered to the patients. Data were stratified for preoperative risk score. Logistic and linear regression analysis tested the influence of different variables on the incidence of allogeneic blood transfusion and the total amount of allogeneic blood.


RESULTS
Of all patients 267 (11.2%) underwent predonation. The incidence of allogeneic packed cell transfusion was reduced from 53% to 19% by autologous predonation (p<0.001). The total amount of allogeneic blood transfused was significantly different between the groups (2.2+/-4.2 vs. 0.84+/-6.3 units; p<0.001).


CONCLUSIONS
Autologous predonation in cardiac surgery was effective in reducing blood transfusions even in the absence of longer preoperative waiting times. It is a safe and effective method to minimize blood transfusion in cardiac surgery.
Dietrich
W
W
Institut für Anästhesiologie, Deutsches Herzzentrum, Klinik an der Technischen Universität München, Lazarettstr. 36, 80636, München. dietrich@dhm.mhn.de
Busley
R
R
Kriner
M
M
D000368:Aged; D001804:Blood Transfusion, Autologous / Q000009:adverse effects; D006348:Cardiac Surgical Procedures; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk