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October 13, 1989, Vol 262, No. 14 >
ARTICLE | October 13, 1989

Autologous Blood Donations Prior to Elective Cardiac Surgery: Title and subTitle BreakSafety and Effect on Subsequent Blood Use FREE

Debra V. Owings, MD; Margot S. Kruskall, MD; Robert L. Thurer, MD; Lillian M. Donovan
[+] Author Affiliations

Reprint requests to Blood Bank, Beth Israel Hospital, 330 Brookline Ave, Boston, MA 02215 (Dr Kruskall).


JAMA. 1989;262(14):1963-1968. doi:10.1001/jama.1989.03430140081029
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References

Blood transfusions are frequently necessary for patients having open heart surgery. Although autologous blood is free of such risks as transfusion-transmitted diseases, the safety and effectiveness of autologous donations by cardiac patients are debated. We analyzed the records of 291 consecutive patients undergoing elective open heart surgery. One hundred seven (36.8%) donated between 1 and 6 U of autologous blood (mean, 3.0 ± 1.5 U) before undergoing surgery. First-time elective coronary artery bypass surgery was the most common indication for autologous donation (90.6% of autologous donors). Problems following donations were infrequent (2 of 326 donations) and without long-term consequences. Among patients having coronary artery bypass surgery who donated autologous blood, 27% required homologous blood transfusions as compared with 82% of other patients undergoing the same procedure. We conclude that autologous blood donations are safe for patients with cardiac disease and effective in significantly reducing homologous blood needs in patients undergoing elective coronary artery bypass surgery.

(JAMA. 1989;262:1963-1968)

REFERENCES

1 +
Killip T.  Twenty years of coronary bypass surgery . N Engl J Med. 1988;;319:366-368.
2 +
Goodnough LT, Kruskall M, Stehling L, et al.  A multi-center audit of transfusion practice in coronary artery bypass (CABG) surgery . Blood. 1988;;72:277a.
3 +
Love TR, Hendren WG, O'Keefe DD, Daggett WM.  Transfusion of predonated autologous blood in elective cardiac surgery . Ann Thorac Surg. 1987;;43:508-512.
4 +
McCarthy PM, Popovsky MA, Schaff HV, et al.  Effect of blood conservation efforts in cardiac operations at the Mayo Clinic . Mayo Clin Proc. 1988;;63:225-229.
5 +
Silver H.  Banked and fresh autologous blood in cardiopulmonary bypass surgery . Transfusion. 1975;;15:600-603.
6 +
Fleming AW, Green DC, Radcliffe JH, St James DM, Fleming EW.  Development of a practical autologous blood transfusion program . Am Surg. 1977;;43:794-801.
7 +
Cove H, Matloff J, Sacks HJ, Sherbecoe R, Goldfinger D.  Autologous blood transfusion in coronary artery bypass surgery . Transfusion. 1976;; 16:245-248.
8 +
Lubin J, Greenberg JJ, Yahr WZ, Haynes JL, Paul E.  The use of autologous blood in open-heart surgery . Transfusion. 1974;;14:602-607.
9 +
Milles G, Langston HT, Dalessandro W. Autologous Transfusions . Springfield, Ill: Charles C Thomas Publisher; 1971;:80-86.
10 +
Dahmen E, Ohlmeier H, Hoppe I.  Eigenblutspende und Eigenbluttransfusion bei kardiochirurgischen Risikopatienten . Thoraxchirurgie. 1978;; 26:27-38.
11 +
Sayers MH.  Autologous blood donation by cardiac surgery patients: wisdom or folly?  In: Maffei LM, Thurer RL, eds. Autologous Blood Transfusion: Current Issues . Arlington, Va: American Association of Blood Banks; 1988;:111-118.
12 +
Sassetti R, Spiess B, Narbone R.  Hemodynamic changes in high risk autologous donors . Transfusion . 1988;;28( (suppl) ):34S.
13 +
Kruskall MS, Glazer EE, Leonard SS, et al.  Utilization and effectiveness of a hospital autologous preoperative blood donor program . Transfusion. 1986;;26:335-340.
14 +
Valeri CR, Zaroulis CG.  Rejuvenation and freezing of outdated stored human red cells . N Engl J Med. 1972;;287:1307-1313.
15 +
Button L, Kruskall MS, Scanlon A, Kevy S.  Rejuvenation of red cells drawn in Adsol to extend autologous red cell storage . Transfusion. 1986;; 26:558.
16 +
Dahmen E, Malchus R, Hoppe I.  Hepatitis after cardiosurgery: frequency and causes: results of a prospective study with use of autologous blood . Thorac Cardiovasc Surg. 1980;;28:1-6.
17 +
Aymard JP, Janot G, Gayet S, et al.  Post-transfusion non-A, non-B hepatitis after cardiac surgery: prospective analysis of donor blood anti-NBc as a predictive indicator of the occurrence of non-A, non-B hepatitis in recipients . Vox Sang. 1986;;51:236-238.
18 +
Grillner L, Bergdahl S, Jyrala A.  Non-A, non-B hepatitis after open-heart surgery in Sweden . Scand J Infect Dis. 1982;;14:171-175.
19 +
Peterman TA, Jaffe HW, Feorino PM, et al.  Transfusion-associated acquired immunodeficiency syndrome in the United States . JAMA. 1985;;254:2913-2917.
20 +
Ward JW, Deppe DA, Samson S, et al.  Risk of human immunodeficiency virus infection from blood donors who later developed the acquired immunodeficiency syndrome . Ann Intern Med. 1987;;106:61-62.
21 +
Donahue D.  Qualifications, management, and care of blood donors . In: Petz LD, Swisher SN, eds. Clinical Practice of Blood Transfusion . New York, NY: Churchill Livingstone Inc; 1981;:199-212.
22 +
Widmann FK, ed. Technical Manual of the American Association of Blood Banks . 9th ed. Arlington, Va: American Association of Blood Banks; 1985;:1-17.
23 +
Pruitt BA, Moncrief JA, Mason AD.  Efficacy of buffered saline as the sole replacement fluid following acute measured hemorrhage in man . J Trauma. 1967;;7:767-782.
24 +
Skillman JJ, Awwad HK, Moore FD.  Plasma protein kinetics of the early transcapillary refill after hemorrhage in man . Surg Gynecol Obstet. 1967;;125:983-996.
25 +
Thurer RL.  Blood conservation in cardiac operations . Mayo Clin Proc. 1988;;63:292-293.
26 +
Weisel RD, Charlesworth DC, Mickleborough LL, et al.  Limitations of blood conservation . J Thorac Cardiovasc Surg. 1984;;88:26-38.
27 +
Cordell AR, Lavender SW.  An appraisal of blood salvage techniques in vascular and cardiac operations . Ann Thorac Surg. 1981;;31:421-425.
28 +
Keeling MM, Gray LA, Brink MA, Hillerich VK, Blank KI.  Intraoperative autotransfusion: experience in 725 consecutive cases . Ann Surg. 1983;;197:536-540.
29 +
Utley JR, Moores WY, Stephens DB.  Blood conservation techniques . Ann Thorac Surg. 1981;;31:482-490.
30 +
Cohn LH, Fosberg AM, Anderson WP, Collins JJ.  The effects of phlebotomy, hemodilution, and autologous transfusion on systemic oxygenation and whole blood utilization in open heart surgery . Chest. 1975;;68:283-287.
31 +
Bayer WL, Coenen WM, Jenkins DC, Zucker ML.  The use of blood and blood components in 1769 patients undergoing open-heart surgery . Ann Thorac Surg. 1980;;29:117-122.
32 +
Winton TL, Charrett EJP, Salerno TA.  The cell saver during cardiac surgery: does it save? Ann Thorac Surg. 1982;;33:379-381.
33 +
Johnson RG, Rosenkrantz KR, Preston RA, Hopkins C, Daggett WM.  The efficacy of postoperative autotransfusion in patients undergoing cardiac operations . Ann Thorac Surg. 1983;;36:173-179.
34 +
Thurer RL, Lytle BW, Cosgrove DM, Loop FD.  Autotransfusion following cardiac operations: a randomized, prospective study . Ann Thorac Surg. 1979;;27:500-507.
35 +
Schaff HV, Hauer J, Gardner TJ, et al.  Routine use of autotransfusion following cardiac surgery: experience in 700 patients . Ann Thorac Surg. 1979;;27:493-499.
36 +
Ochsner JL, Mills NL, Leonard GL, Lawson N.  Fresh autologous blood transfusion with extracorporeal circulation . Ann Surg. 1973;;177:811-817.
37 +
Hallowell P, Bland JHL, Buckley MJ, et al.  Transfusion of fresh autologous blood in open-heart surgery . J Thorac Cardiovasc Surg. 1972;;64:941-948.
38 +
Wagstaffe JG, Clarke AD, Jackson PW.  Reduction of blood loss by restoration of platelet levels using fresh autologous blood after cardiopulmonary bypass . Thorax. 1972;;27:410-414.
39 +
Pliam MB, McGoon DC, Tarhan S.  Failure of transfusion of autologous whole blood to reduce banked blood requirements in open heart surgical patients . J Thorac Cardiovasc Surg. 1975;;70:338-343.
40 +
Sherman MM, Dobnik DB, Dennis RC, Berger RL.  Autologous blood transfusion during cardiopulmonary bypass . Chest. 1976;;70:592-595.
41 +
Hardesty RL, Bayer WL, Bahnson HT.  A technique for the use of autologous fresh blood during open-heart surgery . J Thorac Cardiovasc Surg. 1968;;56:683-688.
42 +
Goodnough LT, Rudnick S, Price T, et al.  Erythropoietin therapy in autologous donors . Blood. 1988;;72:118a.
43 +
Kickler TS, Spivak JL.  Effect of repeated whole blood donations on serum immunoreactive erythropoietin levels in autologous donors . JAMA. 1988;;260:65-67.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Killip T.  Twenty years of coronary bypass surgery . N Engl J Med. 1988;;319:366-368.
2 +
Goodnough LT, Kruskall M, Stehling L, et al.  A multi-center audit of transfusion practice in coronary artery bypass (CABG) surgery . Blood. 1988;;72:277a.
3 +
Love TR, Hendren WG, O'Keefe DD, Daggett WM.  Transfusion of predonated autologous blood in elective cardiac surgery . Ann Thorac Surg. 1987;;43:508-512.
4 +
McCarthy PM, Popovsky MA, Schaff HV, et al.  Effect of blood conservation efforts in cardiac operations at the Mayo Clinic . Mayo Clin Proc. 1988;;63:225-229.
5 +
Silver H.  Banked and fresh autologous blood in cardiopulmonary bypass surgery . Transfusion. 1975;;15:600-603.
6 +
Fleming AW, Green DC, Radcliffe JH, St James DM, Fleming EW.  Development of a practical autologous blood transfusion program . Am Surg. 1977;;43:794-801.
7 +
Cove H, Matloff J, Sacks HJ, Sherbecoe R, Goldfinger D.  Autologous blood transfusion in coronary artery bypass surgery . Transfusion. 1976;; 16:245-248.
8 +
Lubin J, Greenberg JJ, Yahr WZ, Haynes JL, Paul E.  The use of autologous blood in open-heart surgery . Transfusion. 1974;;14:602-607.
9 +
Milles G, Langston HT, Dalessandro W. Autologous Transfusions . Springfield, Ill: Charles C Thomas Publisher; 1971;:80-86.
10 +
Dahmen E, Ohlmeier H, Hoppe I.  Eigenblutspende und Eigenbluttransfusion bei kardiochirurgischen Risikopatienten . Thoraxchirurgie. 1978;; 26:27-38.
11 +
Sayers MH.  Autologous blood donation by cardiac surgery patients: wisdom or folly?  In: Maffei LM, Thurer RL, eds. Autologous Blood Transfusion: Current Issues . Arlington, Va: American Association of Blood Banks; 1988;:111-118.
12 +
Sassetti R, Spiess B, Narbone R.  Hemodynamic changes in high risk autologous donors . Transfusion . 1988;;28( (suppl) ):34S.
13 +
Kruskall MS, Glazer EE, Leonard SS, et al.  Utilization and effectiveness of a hospital autologous preoperative blood donor program . Transfusion. 1986;;26:335-340.
14 +
Valeri CR, Zaroulis CG.  Rejuvenation and freezing of outdated stored human red cells . N Engl J Med. 1972;;287:1307-1313.
15 +
Button L, Kruskall MS, Scanlon A, Kevy S.  Rejuvenation of red cells drawn in Adsol to extend autologous red cell storage . Transfusion. 1986;; 26:558.
16 +
Dahmen E, Malchus R, Hoppe I.  Hepatitis after cardiosurgery: frequency and causes: results of a prospective study with use of autologous blood . Thorac Cardiovasc Surg. 1980;;28:1-6.
17 +
Aymard JP, Janot G, Gayet S, et al.  Post-transfusion non-A, non-B hepatitis after cardiac surgery: prospective analysis of donor blood anti-NBc as a predictive indicator of the occurrence of non-A, non-B hepatitis in recipients . Vox Sang. 1986;;51:236-238.
18 +
Grillner L, Bergdahl S, Jyrala A.  Non-A, non-B hepatitis after open-heart surgery in Sweden . Scand J Infect Dis. 1982;;14:171-175.
19 +
Peterman TA, Jaffe HW, Feorino PM, et al.  Transfusion-associated acquired immunodeficiency syndrome in the United States . JAMA. 1985;;254:2913-2917.
20 +
Ward JW, Deppe DA, Samson S, et al.  Risk of human immunodeficiency virus infection from blood donors who later developed the acquired immunodeficiency syndrome . Ann Intern Med. 1987;;106:61-62.
21 +
Donahue D.  Qualifications, management, and care of blood donors . In: Petz LD, Swisher SN, eds. Clinical Practice of Blood Transfusion . New York, NY: Churchill Livingstone Inc; 1981;:199-212.
22 +
Widmann FK, ed. Technical Manual of the American Association of Blood Banks . 9th ed. Arlington, Va: American Association of Blood Banks; 1985;:1-17.
23 +
Pruitt BA, Moncrief JA, Mason AD.  Efficacy of buffered saline as the sole replacement fluid following acute measured hemorrhage in man . J Trauma. 1967;;7:767-782.
24 +
Skillman JJ, Awwad HK, Moore FD.  Plasma protein kinetics of the early transcapillary refill after hemorrhage in man . Surg Gynecol Obstet. 1967;;125:983-996.
25 +
Thurer RL.  Blood conservation in cardiac operations . Mayo Clin Proc. 1988;;63:292-293.
26 +
Weisel RD, Charlesworth DC, Mickleborough LL, et al.  Limitations of blood conservation . J Thorac Cardiovasc Surg. 1984;;88:26-38.
27 +
Cordell AR, Lavender SW.  An appraisal of blood salvage techniques in vascular and cardiac operations . Ann Thorac Surg. 1981;;31:421-425.
28 +
Keeling MM, Gray LA, Brink MA, Hillerich VK, Blank KI.  Intraoperative autotransfusion: experience in 725 consecutive cases . Ann Surg. 1983;;197:536-540.
29 +
Utley JR, Moores WY, Stephens DB.  Blood conservation techniques . Ann Thorac Surg. 1981;;31:482-490.
30 +
Cohn LH, Fosberg AM, Anderson WP, Collins JJ.  The effects of phlebotomy, hemodilution, and autologous transfusion on systemic oxygenation and whole blood utilization in open heart surgery . Chest. 1975;;68:283-287.
31 +
Bayer WL, Coenen WM, Jenkins DC, Zucker ML.  The use of blood and blood components in 1769 patients undergoing open-heart surgery . Ann Thorac Surg. 1980;;29:117-122.
32 +
Winton TL, Charrett EJP, Salerno TA.  The cell saver during cardiac surgery: does it save? Ann Thorac Surg. 1982;;33:379-381.
33 +
Johnson RG, Rosenkrantz KR, Preston RA, Hopkins C, Daggett WM.  The efficacy of postoperative autotransfusion in patients undergoing cardiac operations . Ann Thorac Surg. 1983;;36:173-179.
34 +
Thurer RL, Lytle BW, Cosgrove DM, Loop FD.  Autotransfusion following cardiac operations: a randomized, prospective study . Ann Thorac Surg. 1979;;27:500-507.
35 +
Schaff HV, Hauer J, Gardner TJ, et al.  Routine use of autotransfusion following cardiac surgery: experience in 700 patients . Ann Thorac Surg. 1979;;27:493-499.
36 +
Ochsner JL, Mills NL, Leonard GL, Lawson N.  Fresh autologous blood transfusion with extracorporeal circulation . Ann Surg. 1973;;177:811-817.
37 +
Hallowell P, Bland JHL, Buckley MJ, et al.  Transfusion of fresh autologous blood in open-heart surgery . J Thorac Cardiovasc Surg. 1972;;64:941-948.
38 +
Wagstaffe JG, Clarke AD, Jackson PW.  Reduction of blood loss by restoration of platelet levels using fresh autologous blood after cardiopulmonary bypass . Thorax. 1972;;27:410-414.
39 +
Pliam MB, McGoon DC, Tarhan S.  Failure of transfusion of autologous whole blood to reduce banked blood requirements in open heart surgical patients . J Thorac Cardiovasc Surg. 1975;;70:338-343.
40 +
Sherman MM, Dobnik DB, Dennis RC, Berger RL.  Autologous blood transfusion during cardiopulmonary bypass . Chest. 1976;;70:592-595.
41 +
Hardesty RL, Bayer WL, Bahnson HT.  A technique for the use of autologous fresh blood during open-heart surgery . J Thorac Cardiovasc Surg. 1968;;56:683-688.
42 +
Goodnough LT, Rudnick S, Price T, et al.  Erythropoietin therapy in autologous donors . Blood. 1988;;72:118a.
43 +
Kickler TS, Spivak JL.  Effect of repeated whole blood donations on serum immunoreactive erythropoietin levels in autologous donors . JAMA. 1988;;260:65-67.

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