Preoperative autologous blood donation and plateletpheresis in patients undergoing elective cardiac operations--factors that influence the need for homologous blood transfusion.

Abstract

An increased awareness of the adverse effects of homologous blood transfusion prompted us to initiate a blood conservation program consisting of preoperative autologous blood donation and platelet-rich plasma-pheresis. We studied 120 patients who underwent elective cardiac surgery at Aomori General Hospital between January 1991 and September 1994. If their hemoglobin values exceeded 12 g/ml, 400 g of whole blood was drawn 3 times before the operation. Platelet-poor plasma was collected 10 days before the operation and platelet-rich plasma was collected the day before the operation. However, despite participation in this program, 42 of 120 patients (35%) required homologous blood transfusion perioperatively. Factors that influenced the need for homologous blood transfusion were identified retrospectively, with the following found to be significant by univariate analysis: operative procedures performed, cardiopulmonary bypass time, and the amount of autologous blood and autologous plasma donated. Although the effectiveness of our blood conservation procedure remains to be verified, it reduced the need for the transfusion of homologous blood. Thus, additional units of autologous blood are required to obviate the need for homologous transfusion in patients undergoing long cardiopulmonary bypass procedures.