Predeposit Autologous Blood Donation Research Articles

Predeposit Autologous Blood Donation in Rh(D)-Negative Pregnant Women: A Single-Center Study.

Objective The primary purpose of this study was to assess the practicability of predeposit autologous blood donation (PABD) in the practice of Rh(D)-negative pregnant women. Materials and Methods A cohort of 405 Rh(D)-negative pregnant women who had a delivery in the comprehensive tertiary hospital in Nanjing was analyzed retrospectively, over 10 years. Results After PABD, 203 women experienced a slight drop in mean hemoglobin of 5.32 ± 0.5 g/L (PABD-associated anemia was not featured in our study). Thirteen women who received allogeneic blood might benefit from PABD practically. Conclusion PABD is applicable for Rh(D)-negative pregnant women, as it ensures the availability of the patient's blood in the event of perinatal hemorrhage, thus minimizing the need for transfusion from external sources. Despite the autologous blood reinfusion of low proportion, PABD could still serve as an alternative when allogeneic blood resources are scarce. However, one challenge in the future is to identify candidates who may benefit most from PABD. Also, more attention is needed to raise awareness of patient blood management. Recommended strategies include early screening and treatment of anemia, hemostasis promotion, and blood loss reduction. Replacement of allogeneic transfusion with autotransfusion could be referred to where feasible. We believe that PABD still has a promising potential for application in Rh(D)-negative pregnant women.

Predictors of Blood Loss During Orthognathic Surgery and the Need for Pre-Deposit Autologous Blood Donation.

The aim of this study was to identify the clinicolaboratory predictors of relative blood loss (RBL) during orthognathic surgery and determine the need for predeposit autologous blood donation (PABD) for the surgery. Using a retrospective study design, 297 patients who underwent bimaxillary orthognathic surgery between 2016 and 2020 were enrolled. To investigate patient-specific risk factors, we calculated the allowable blood loss (ABL) for each patient and RBL as the ratio of estimated intraoperative blood loss (EiBL) to ABL. The correlations between the clinico-laboratory variables and EiBL and RBL were analyzed using stepwise multivariate regression analysis, and independent t test and one-way ANOVA were performed.There was no significant difference in transfusion rate between the PABD group (N = 202/279) and non-PABD group (N = 77/279) ( P = 0.052). Sex ( P < 0.001), body mass index class ( P = 0.001), operative time ( P < 0.001), and baseline hematocrit ( P < 0.001) were significant predictors of EIBL and RBL. EIBL exceeded ABL in only 2 patients. The significant factors of RBL in orthognathic surgery were hematocrit, body mass index, and operative time. Clinicians should be more careful about bleeding in patients with low baseline hematocrit level or high body mass index, or those expected to undergo prolonged surgeries owing to a complicated surgical plan. The need for PABD before orthognathic surgery is low.

The current status of autologous blood transfusion in Japan – The importance of pre-deposit autologous blood donation program and the needs to achieve patient blood management

BackgroundAutologous blood transfusion (ABT) is currently considered the safest transfusion, since the risks of allogeneic immunological reaction and viral transmission are theoretically null. Although its use has declined in Western countries in the recent decade, it has been progressively expanded in Japan. With the widening of the concept of patient blood management (PBM), which aims to prevent the harmful adverse effects of the exposure to allogeneic blood, the importance of the ABT has once again gained interest. Study design and methodsHere, we retrospectively analyzed the cases pre-depositing autologous blood for an elective surgery in the period of January 2000 to December 2010 in our hospital, where a pre-deposit autologous blood donation (PAD) program has been established in 2006, in an attempt to analyze the improvements achieved, and the problems remaining to achieve patient blood management. ResultsThe PAD program contributed for the further improvement of ABT, and the number of participating patients increased, especially in the period 2002–2003, when the idea of PAD program implementation came out. By simple extrapolation of the ABT data to allogeneic blood, ABT was found to be superior in terms of cost-effectiveness. However, problems such as the high wastage rate, and the inappropriate transfusion triggers remain to be solved. ConclusionABT plays the central role in PBM, but to achieve the real PBM, there is need to indicate ABT appropriately, according to the individual needs, and use it adequately, without discarding. Our present data reflect the present status of the ABT performance in Japan, and will serve as the basis for the development of strategies to achieve safe and appropriate performance of ABT, and consequently, achieve PBM.

Inclusion of Predeposit Autologous Blood Donation and 33 % Hypertonic Saline Solution in the Surgical Management of Patients with Peritoneal Echinococcosis

We praise Majbar and colleagues [1] for their brilliant and profitable attempt at classifying peritoneal echinococcosis (PE) into four main categories. However, we remain curious about whether they tackled the following two topics that so far have been overlooked by the pertinent literature: the potential eligibility for predeposit autologous blood donation (PABD) in patients with PE and the use of 33 % hypertonic saline solution during surgical or minimally invasive procedures [1]. Recently, in fact, we grappled with these issues in the surgical management of a 29-year-old male patient affected by a disseminated form of PE. Two echinococcal cysts were located in the greater and lesser omentum, three in the liver (segments II, IVa, and VII), one in the right subdiaphragmatic peritoneum, and one in the retrovesical pouch. Anticipating the risk of intraperitoneal bleeding due to extensive hydatid disease, we offered the patient a preoperative evaluation for PABD; however, the consulted transfusion practitioner did not alert us to the risk of recruiting the flatworm from the circulating blood and reconveying the infecting agent through the transfusion. At surgery, after walling off the operative field with packs soaked in 33 % hypertonic saline solution, we performed radical resection for three cysts and partial excision (deroofing plus drainage and chemical inactivation by means of the aforementioned scolicidal agent) for the remaining five cysts which could not be totally extirpated. Altogether, 6,500 mL of 33 % saline solution were used during the procedure and the postoperative course was uneventful. Surgery is the only curative treatment for patients with PE, but may expose the patient to bleeding complications, especially when the hydatid cysts involve or abut wellvascularized structures. In this regard, we know of some cases from the literature of uncontrollable intraoperative bleeding requiring prompt blood transfusions and resuscitation [2]. Surgical treatment of hydatidosis has reported mortality and morbidity rates up to 8 and 69 %, respectively; however, the real incidence of hemorrhagic events is unknown. The first and only case of PABD profitably performed in a patient with a liver hydatid cyst was reported by Roussel et al. [3]. The authors infer that PABD is a safe procedure in patients without signs of cystic crevice such as abdominal tenderness, hypereosinophilia, and serum IgE elevation. Our patient was thought not to be eligible for PABD, although none of the above-mentioned features were present. Of interest, the past current international guidelines for PABD do not include hydatidosis among the contraindications, rendering this subject more intriguing and baffling at the same time [4]. As for the scolicidal agent, the guidelines of the World Health Organization do not mention 33 % hypertonic saline solution, and only a few cases have reported on its use for hydatid disease, although none of them dealt with PE [5]. Even though some authors warn of potentially serious complications following the use of saline, such as injuries to the peritoneal surface and hypernatremia, it helped us permanently eradicate echinococcosis in our patient (follow-up is now 40 months) without any complications. We advocate the use for PABD in otherwise healthy patients with PE and encourage the use of 33 % saline solution in such patients as a safe and efficacious scolicidal agent. E. Virgilio (&) T. Bocchetti G. Balducci General Surgery Unit 1, Faculty of Medicine and Psychology La Sapienza, Hospital St. Andrea, via di Grottarossa 1035-39, 00189 Rome, Italy e-mail: aresedo1992@yahoo.it

Guidelines for policies on alternatives to allogeneic blood transfusion. 1. Predeposit autologous blood donation and transfusion

SUMMARY This is the first of a series of newly prepared guidelines on alternatives to allogeneic blood transfusion. Further guidelines including the use of cell salvage and of pharmacological approaches to blood conservation will be published in due course. Decades of clinical application demonstrate that it is quite feasible to auto-transfuse blood that has been collected and stored for an interval of up to 6 weeks in standard storage media, and that up to three standard collection volumes (approximately 500 mL) can be collected from normal-sized adults (over 50 kg) during that interval. Furthermore, systems have been developed to reduce risk to participants and to boost haemoglobin (Hb) production during and after the procedure. However, such pre-operative autologous donations (PAD) are not without risk, are of low clinical efficacy and are poorly cost-effective for the vast majority of patients in the UK. These guidelines update those previously issued by the BCSH and do not recommend the practice and use of PAD unless the clinical circumstances are exceptional. They also give an update on the legal regulatory circumstances pertaining to the UK following recent European Directives.

BCSH guidelines for policies on alternatives to allogeneic blood transfusion. 1. Predeposit autologous blood donation and transfusion, August 2006 ‐ Reply from the Chairman of the BCSH Transfusion Task Force

Transfusion MedicineVolume 17, Issue 5 p. 366-366 BCSH guidelines for policies on alternatives to allogeneic blood transfusion. 1. Predeposit autologous blood donation and transfusion, August 2006 - Reply from the Chairman of the BCSH Transfusion Task Force F. Boulton, Corresponding Author F. Boulton National Blood Service, Southampton, UKFrank Boulton, British Committee for Standards in Haematology, 100 White Lion Street, London N1 9PF, UK.e-mail: frank.boulton@gmail.com, frank.boulton@nbs.nhs.ukSearch for more papers by this author F. Boulton, Corresponding Author F. Boulton National Blood Service, Southampton, UKFrank Boulton, British Committee for Standards in Haematology, 100 White Lion Street, London N1 9PF, UK.e-mail: frank.boulton@gmail.com, frank.boulton@nbs.nhs.ukSearch for more papers by this author First published: 27 September 2007 https://doi.org/10.1111/j.1365-3148.2007.00753.xCitations: 12Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume17, Issue5October 2007Pages 366-366 RelatedInformation

BCSH guidelines for policies on alternatives to allogeneic blood transfusion. 1. Predeposit autologous blood donation and transfusion, August 2006

BCSH guidelines for policies on alternatives to allogeneic blood transfusion. 1. Predeposit autologous blood donation and transfusion, August 2006

Pre‐operative predeposit autologous donation in children presenting for elective surgery: a review

Predeposit Autologous blood donation (PAD) in children decreases the life-time complications associated with allogeneic blood. These complications include transmission of known or unknown pathogens and alloimmunization against future blood transfusions, organ transplants and pregnancies. In view of the potential long term benefits of PAD should it be considered a component of paediatric blood conservation programs. This paper reviews the literature to explore the risk of benefit analysis of adopting PAD in paediatric practice.

Preoperative autologous blood donation for bone marrow harvests: Are we wasting donors' time and blood?

Predeposit autologous blood donation (PAD) is frequently offered to bone marrow donors, but its cost-effectiveness is dubious. We assessed the impact of PAD and bone marrow donation on transfusion requirements; and the use of donated blood units in a retrospective study of 61 bone marrow donors. The mean haemoglobin (Hb) concentration fell from 12.9 to 11.8 g dL(-1) in women who predonated one unit and from 13.2 to 10.9 g dL(-1) in those who predonated two units. In men who donated two units of blood, the Hb concentration decreased to 12.9 g dL(-1). Bone marrow harvest led to a further decline in Hb concentration by 2.3 g dL(-1) in women and by 2.4 g dL(-1) in men. The postharvest Hb fell to <or=9.0 g dL(-1) in 39% of female and in 6% of the male donors; all but one of them had predonated blood. The utilization rate of autologous units was 45.6%, with 55% of women and 24% of men receiving autologous blood. In females, 59% of transfused autologous units were given with the donor's Hb of >or= 9.0 g dL(-1); overtransfusion was even more apparent in men: 71% units were given with a Hb >or= 10.0 g dL(-1). PAD in bone marrow donors is associated with high wastage and increases the likelihood of requiring a transfusion. We recommend that PAD should not be routinely offered to bone marrow donors.

A case of bone pain caused by erythropoietin

A 62-year-old female patient was hospitalized prior to undergoing an operation for endometrial cancer. She received erythropoietin in doses of 6,000 IU every other day in preparation for predeposit autologous blood donation. About 4 hours after the injection, the patient felt a back pain in the pelvic region. This is the first report of bone pain caused by erythropoietin.

貯血式自己血輸血における遺伝子組換えヒトエリスロポエチン（ｒ‐ＨｕＥＰＯ）の投与法とその効果

Predeposit autologous blood donation (PABD) with recombinant human erythropoietin (r-HuEPO) has recently come into widespread use. To determine the optimal route of r-HuEPO administration for PABD, we investigated the effects of r-HuEPO by different routes on predeposit autologous 1, 200ml blood donation courses in 71 patients undergoing elective orthopedic surgery. The patients were divided into three groups as follows: 36 patients were given r-HuEPO two or three times a week intravenously, 21 were given r-HuEPO once a week subcutaneously, and 14 without r-HuEPO served as controls. The increase in hemoglobin concentration in both r-HuEPO administration groups (3.46±1.16g/dl intravenous; 2.40±0.76g/dl subcutaneous) was significantly greater than that in the controls (1.47±1.04g/dl). To further compare the effects of r-HuEPO by both routes, regression analysis between increase in hemoglobin concentration per week period and total dose of r-HuEPO divided by body weight was done. The hemoglobin increase (y) demonstrated a significant positive linear correlation with r-HuEPO dose (x) in both groups (y=5.0×10-4+0.28, r=0.86 for the intravenous group, y=4.7×10-4+0.37, r=0.55 for the subcutaneous group), with the two lines revealing no significant difference from each other. In conclusion, both routes of r-HuEPO administration given under the same total dose are equally efficacious in raising hemoglobin concentration level.

Use of predeposit autologous blood and intraoperative autotransfusion in urologic cancer surgery

A total of 20 patients underwent major urologic cancer surgery with the combined use of predeposit autologous blood and intraoperative autotransfusion with the Haemonetics Cell Saver. The estimated blood loss ranged from 400 to 2,000 mL (mean 1,208 mL). Total transfusion requirements for the 20 patients were 85.5 units of which 82.5 (96 %) were autologous. Predeposit autologous blood accounted for 53 percent, intraoperative autotransfusion blood 43 percent, and homologous blood 4 percent of the total transfusion requirements Of the 20 patients in the study, only 1 received homologous blood. There were no complications related to either modality of autotransfusion. Our data suggest that using the combined modalities of predeposit autologous blood donation and intraoperative autotransfusion, major urologic cancer surgery can be performed without homologous blood in most cases.

The application of recombinant erythropoietin in anemic patients with cancer.

Recombinant human erythropoietin (r-HuEPO) has been shown to correct anemia and alleviate transfusion dependency in patients with end-stage renal disease, to ameliorate anemia and reduce transfusion requirements in anemic patients with acquired immunodeficiency syndrome, to correct anemia in patients with rheumatoid arthritis, and to facilitate predeposit autologous blood donation. Cancer is frequently complicated by anemia, and a survey of serum erythropoietin concentrations in anemic cancer patients showed inappropriately low concentrations for the degree of anemia. Initial clinical trials suggest that r-HuEPO can correct the anemia associated with malignancy, but the exact role of the recombinant hormone in this situation remains to be defined.

遺伝子組換えヒトエリスロポエチンＫＲＮ５７０２週１回皮下投与を併用する貯血式自己血輸血法 多施設共同初期第ＩＩ相試験

遺伝子組換えヒトエリスロポエチンＫＲＮ５７０２週１回皮下投与を併用する貯血式自己血輸血法 多施設共同初期第ＩＩ相試験

Feasibility of a Predeposit Autologous Blood Donation Program in Colorectal Cancer Patients: Results from a Randomized Clinical Study

The hematologic and transfusion data of a multicenter randomized trial investigating the effect of blood transfusions on the 5-year survival were used to study the feasibility of an autologous blood donation program in colorectal cancer patients. Three hundred and ten patients were randomized for autologous blood transfusions (predeposition of 2 units) or homologous blood transfusions, and transfusion rules were standardized. The Hb level in the patients who donated blood decreased by 20.1 ± 1.3 g/l (mean ± SEM) preoperatively and 4.5 ± 1.8 g/l postoperatively, and in controls 3.7 ± 1.1 g/l and 16.5 ± 1.9 g/l (significantly different between the two groups, both pre- and postoperatively: p<0.01). Because blood loss and number of transfusions were similar in both groups, this indicated that either preoperative or postoperative erythropoiesis is stronger in patients who had donated blood. Twenty-three percent of the autologous patients and 61% of the homologous patients were exposed to homologous blood. The effectiveness of the procedure differed per tumor localization. In patients with a right-sided colon carcinoma, 22% of the control patients needed homologous blood, compared to 10% of the autologous patients. In patients with other colon carcinomas, this was 52 and 16% , respectively, and in patients with a rectal carcinoma 85 and 41%. We conclude that predeposition of 2 units of blood for colorectal cancer surgery is feasible and useful to prevent homologous blood usage in a significant number of patients with left colon carcinoma or rectal carcinoma.