Predictors of allogenic blood transfusion in elective cardiac surgery after preoperative autologous blood donation

Abstract

Preoperative autologous blood donation (PAD) is important for reducing exposure to allogenic blood in cardiac surgery. Unfortunately, even after PAD, allogenic blood transfusion is not always avoided. We investigated the predictors of blood component usage during elective cardiac surgery in patients prepared with PAD. Clinical data were collected for 143 consecutive patients (103 men and 40 women; mean age, 62 +/- 9 years) who underwent elective cardiac surgery after PAD (959 +/- 240 ml), often using iron supplement and recombinant human erythropoietin. Allogenic blood transfusion was avoided during and after surgery in 107 patients (75%), whereas 36 patients required an allogenic transfusion (4.1 +/- 3.8 U of packed red cells, 3.4 +/- 4.1 U of fresh frozen plasma, and 5.8 +/- 11.0 U of platelet concentrate). The independent factors for perioperative allogenic blood transfusion in these patients included the pre-donation hemoglobin value, the preoperative platelet count, and the lowest hemoglobin value during cardiopulmonary bypass. Even with PAD for elective cardiac surgery, patients whose pre-donation hemoglobin value and preoperative platelet count are low may require allogenic blood transfusion.