title: Preoperative Autologous Blood Donation: Waning Indications in an Era of Improved Blood Safety.
abstract: A downward trend in preoperative autologous donation (PAD) continues in Europe and the Americas, with many jurisdictions only funding medically necessary collections at present. This is the result of decreasing real and perceived residual risks of allogeneic transfusion-transmitted disease and the declining need for transfusion due to patient blood management, which have also led to escalating logistical and cost constraints for PAD programs. We outline collection trends in North America, Europe, and Latin America and review the benefits, risks, effectiveness, and safety of PAD. Important elements of informed consent follow from these points. Evidence-based medical criteria for PAD and autologous transfusion are discussed as are methods to optimize autologous collection timing to regenerate donated red cells. Recommendations for identification of patients whose risk-to-benefit ratio suggests substantial benefit compared with other autologous blood salvage and anemia management alternatives conclude the review.
authors.affiliation: Blood Systems, Inc, Scottsdale, AZ. Electronic address: rvassallo@bloodsystems.org.
authors.forename: Ralph
authors.initials: R
authors.lastname: Vassallo
authors.affiliation: Canadian Blood Services, Ottowa, ON, Canada.
authors.forename: Mindy
authors.initials: M
authors.lastname: Goldman
authors.affiliation: Medical Affairs, Héma-Québec, Québec, QC, Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Germain
authors.affiliation: Hemotherapy Section, Hospital Clinic de Barcelona, Barcelona, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Lozano
mesh_terms: D001782:Blood Donors; D058731:Blood Safety / Q000592:standards / Q000639:trends*; D001804:Blood Transfusion, Autologous / Q000191:economics / Q000592:standards / Q000639:trends*; D003362:Cost-Benefit Analysis; D006801:Humans; D017410:Practice Guidelines as Topic; D057234:Preoperative Period; D058996:Quality Improvement; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000592:standards
keywords: Autologous blood transfusion; Blood donors; Patient blood management