Abstract
Although preoperative autologous blood donation is employed in elective surgery, this is declining because of the increasingly safe allogeneic blood supply. However, it continues to be used because of the public's perception of allogeneic blood risks and increasing blood shortages. Patients may donate a unit of blood (450 ± 45 ml) as often as twice weekly, up to 72 hours before surgery. Preoperative autologous blood is most beneficial in procedures that cause significant blood loss. It has been determined that preoperative autologous blood donation is poorly cost-effective; the use of this procedure must be based on evidence that it is safe and of value for the patient.
Highlights
Preoperative autologous blood donation (PAD) was developed and promoted [1] in the surgical arena in response to medical and legal pressures to minimize exposure to allogeneic blood
Improvements in blood safety have led to a decline in the use of PAD (Table 1) and in interest in exploring other autologous blood procurement strategies
Public perception of blood safety and the reluctance to accept allogeneic blood transfusion in the elective transfusion setting [4], along with emerging blood inventory shortages, render the application of autologous blood procurement strategies a subject of ongoing debate
Summary
Preoperative autologous blood donation (PAD) was developed and promoted [1] in the surgical arena in response to medical and legal pressures to minimize exposure to allogeneic blood. PAD became accepted as a standard practice in certain elective surgical settings, such as total joint replacement surgery, so that by 1992 more than 6% of the blood transfused in the USA was autologous [3]. Patients undergoing PAD may donate a unit (450 ± 45 ml, or up to 10.5 ml/kg body weight) of blood as often as twice weekly, until 72 hours before surgery.
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