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Ann Thorac Surg 1987;43:508-512
© 1987 The Society of Thoracic Surgeons
From the Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA
Accepted for publication July 28, 1986.
* Address reprint requests to Dr. Daggett, Department of Surgery, Massachusetts General Hospital, Boston, MA 02114
Despite blood conservation techniques, the average transfusion requirement in patients undergoing elective cardiac surgical procedures remains 1 to 3 units. We studied the efficacy of predonated autologous blood in decreasing homologous transfusion in two matched groups of 58 patients each. Group 1 received homologous blood perioperatively, and Group 2 was transfused with predonated autologous blood. An average of 1.97 units was predonated in Group 2 over 18 days. This resulted in a decline in whole blood hemoglobin concentration of 2.2 gm/dl. No complications resulted from phlebotomy in this ambulatory population consisting predominantly of patients with coronary artery disease. Transfusion of an average of 1.7 units of autologous blood in Group 2 reduced the volume of homologous transfusion by 46% compared with Group 1 (p < .01). In Group 1, 38% of patients required no homologous transfusion compared with 64% in Group 2 (p < .02). There were no complications related to autologous blood transfusion. Total transfusion requirement was related to the length of cardiopulmonary bypass. We conclude that autologous predonation is a simple, safe, and cost-effective method of reducing homologous transfusion and thereby decreasing the risk of transfusion-related reactions and infections.
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