Effect of combined preoperative donation and normovolemic hemodilutional autologous blood transfusions in extensive operations for gynecologic tumors

Abstract

The aim of this study was to retrospectively evaluate the effect of the combination of preoperative donation and acute normovolemic hemodilution of the autologous blood in gynecologic operations. The records of 42 patients undergoing extensive gynecologic operations with a blood loss of 800 ml and who received either no autologous transfusion (n = 7), hemodilution alone (n = 19) or the combination of preoperative donation and hemodilution (n = 16) were reviewed. The incidence and volume of allogeneic blood transfusion and postoperative anemia were analyzed. The incidence of allogeneic blood transfusions was 85.7%, 26.3% (P = 0.02), and 20% (P < 0.01), respectively for no autologous, hemodilution alone, and combined groups. The ratio of transfused volume to blood loss was 60.6%, 42.0% (P = 0.03), and 32.0% (P = 0.04), respectively. Postoperative hemoglobins were significantly higher (P < 0.01) in the combined group than the hemodilution group on days one, seven and 14. The combination of preoperative donation and acute normovolemic hemodilution of the autologous blood is effective and further prospective studies may confirm reduced need and risk of allogeneic transfusion.