A Single Center's Retrospective Review of Blood Transfusion Following Allogeneic Bone Marrow Donation

Abstract

Topic Significance & Study Purpose/Background/Rationale Bone marrow harvesting is the preferred method of hematopoetic stem cell acquisition from allogeneic donors for many types of transplant recipients. Due to the vast amount of red blood cells located in the marrow, BM donors are at an increased risk for anemia following BM donation and therefore may require a blood transfusion. Blood transfusions pose an increased risk of complications. Methods, Intervention, & Analysis Retrospective review of all pediatric and adult BM donors at our institution from 1/9/2014 through 10/9/2018. Findings & Interpretation 55 donors underwent a BM harvest procedure for donation during this time frame. Donors’ ages ranged from 3 years to 56 years with a mean age of 27.2 years. 12 donors were pediatric ( 18years). Autologous PRBC unit(s) were collected on 21 adult donors and 0 pediatric donors. Center guidelines for autologous PRBC donation include assessment of the following: Donor age (adult donors only), donor Hemoglobin/Hematocrit (H/H) at physical exam evaluation, and time frame to donation. Of the 55 donors harvested, 14 received PRBC transfusion following their BM donation. 11 donors received autologous PRBC units while 3 received allogeneic transfusions. Of the 3 allogeneic PRBC transfusions, 2 were adult donors and 1 was a pediatric donor. The BM volume harvested from donors ranged from 5ml/kg to 31.2ml/kg. The mean volume harvested from donors=16.6ml BM/kg. Pre-donation H/H was performed on all donors within 24 hours of their donation date. Results ranged from hemoglobin=9.8-18gms/dl; hematocrit=31.8-51.8%. A post-donation H/H was completed immediately following their BM harvest procedure. Results ranged from hemoglobin=6.8-14.4gms/dl; hematocrit=20.7-40.6%. On average, post-donation H/H dropped by hemoglobin= 2.8gms/dl; hematocrit= 8.2%. The decision for PRBC transfusion at our center is based on: physician discretion, post-donation H/H, and donor condition. Discussion & Implications Individual donor assessment prior to donation is critical to determine if autologous PRBC collection is needed. Following donation, careful assessment of the donor is required to determine if the risk of transfusion is necessary.