Utilization and effectiveness of a hospital autologous preoperative blood donor program

Abstract

The utilization and effectiveness of a hospital preoperative autologous blood donation program were analyzed. Over 16 months, 180 donors, or 11.6 percent of eligible patients (those undergoing elective surgical procedures where blood was routinely crossmatched), were enrolled in the program. They donated an average of 2.2 units of red cells, or 59 percent of the mean order of 3.7 units. Donations were completed in 17.9 days, leaving 10.7 days between the last donation and hospitalization. Of all scheduled donations, 25.5 percent were cancelled due to deferrals; 47.8 percent of patients were deferred at least once. Most patients were able to donate a unit of blood weekly, with minimal drops in hematocrit (mean 3.2%). The reaction rate, 4.8 percent, was comparable to figures reported for homologous donors. Nearly two-thirds of participants used no homologous blood during their hospitalization: 28.6 percent used no blood whatsoever, and 36.9 percent used only autologous components. Including released autologous components subsequently administered to other recipients, transfused autologous red cells were 2.1 percent and fresh-frozen plasma (FFP) 7.2 percent of the hospital's blood supply. Although the high deferral rate complicated the administration of the program, this complication was offset by the demonstration of donor safety, reduction in the proportion of patients who used homologous blood, and the contribution of autologous blood components to the hospital's blood inventory.