[The safety of preoperative mechanical autologous plasma donation]

Abstract

Preoperatively performed plasmaphereses in elective surgery enables the patients not only to have an autologous product retransfused but also to receive a product that contains proteins, coagulation factors and immunoglobulins, both in physiological concentration and composition. Moreover, it is a very effective volume substitute, especially in cases in which a great intraoperative blood loss and/or an intense hemodilution may have caused disorders of the coagulatory system due to loss of coagulation factors as well as due to their dilution. Despite the fact that in our study (7540 preoperative autologous plasmaphereses in 4157 patients in 1989) approximately one-third of the patients was older than 70 years and more than 50% had to be put into group IV of the extended/modified ASA-Score, the rate of side effects accompanying autologous plasmapheresis is only 1.3%. No serious or even fatal complications occurred, and all the day-case-patients coming to the hospital just for autologous donations left for home on the same day. Our results demonstrate that a preoperatively performed autologous donation is not only a very effective, but also a very safe method to reduce the need for homologous blood products. If, in elective surgery, a preoperative autologous donation is considered necessary due to the expected blood loss, the general rule for autologous donation is: A patient who is not fit for autologous donation is not fit for elective surgery, either.