Safety of Preoperative Autologous Blood Donations in Cardiac Surgery

Abstract

Background: The aim of this study was to assess the safety of preoperative autologous blood donation (PABD) during cardiac surgery. Methods: 64 patients undergoing first-time elective cardiac surgery were prospectively followed up during PABD before cardiac surgery. Three blood donations in weekly intervals were performed, and all patients received oral (350 mg/day FE+) or i.v. iron (150 mg /week) supplementation. In addition there were 2 subgroups receiving recombinant human erythropoietin (rh-EPO; 10,000 U s.c.) during each donation. 24 patients without PABD served as controls. Results: All patients tolerated the three PABDs before cardiac surgery without any major adverse events or complications. Hemodynamic parameters (heart rate and blood pressure) showed a decrease of less than 10% after donation. On the visual assessment scale, less than 10% of the patients indicated discomfort. None of the patients required rehospitalization or additional treatment in the donation phase before surgery. Conclusion: PABD before cardiac surgery is feasible and safe. No differences could be found between peroral and i.v. iron supplementation. The subgroups receiving rh-EPO showed smaller decreases in hemoglobin level before surgery than the placebo groups. Thus, we can recommend PABD before cardiac surgery if strict selection criteria and an optimal monitoring of the patient during donations are met.