Autologous blood transfusion
Autologous blood transfusion is a medical procedure in which a patient receives their own blood during surgery, intended to replace blood lost during the operation. This process is typically considered for patients undergoing surgical procedures related to various types of cancer, following a thorough evaluation by a physician. Key considerations for eligibility include the anticipated need for blood, the patient’s specific type of cancer, and any existing medical conditions.
Before surgery, patients may participate in preoperative autologous blood donation, where they donate their blood in advance, which is then stored for future use. During surgery, different systems can be employed to collect and reinfuse the blood, ensuring that the patient is continuously monitored for any adverse reactions. While the risks associated with autologous blood transfusion are generally low, they include the potential for reinfusion of cancer cells and changes in blood composition. Ultimately, the goal of this procedure is to reduce blood loss and contribute to improved surgical outcomes, making it a significant option for certain surgical patients.
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Subject Terms
Autologous blood transfusion
Also known as: Preoperative autologous blood donation (PABD), intraoperative blood salvage, postoperative blood salvage, acute normovolemic hemodilution (ANH)
Definition: Autologous blood transfusion is the collecting and reinfusing of a patient’s own blood. Collection is done before surgery and/or during or after the surgical procedure.
Cancers treated: All types of cancer, based on the physician’s decision
Why performed: Autologous blood transfusion is performed to replace blood lost as a result of surgery.
Patient preparation: A physician evaluates the patient to determine whether autologous transfusion is appropriate. The decision is based on established standards. The criteria that the physician uses include the likelihood of the patient needing blood during or after surgery, the type of cancer, and other medical conditions that the patient has. There must also be an autologous donor/transfusion program available to the patient, adequate time to collect blood prior to surgery, and equipment available for the collection and reinfusion of blood during surgery.
Steps of the procedure: The physician writes an order for autologous transfusion. For preoperative autologous blood donation (PABD), the patient donates one or more units of blood at a blood donor center. The donor center staff attaches special labels to the unit of blood indicating it is for a specific patient. Blood collected prior to surgery is stored for up to forty-two days, separately from other blood.
Two systems are available for the collection and reinfusion of blood during surgery. One system is semiautomated: Blood is collected, washed, and transfused to the patient. The other system is a suction system that collects the blood and returns it to the patient without washing. The patient is constantly monitored by anesthesia staff.
In acute normovolemic hemodilution, blood is removed, and, at the same time, a solution to maintain fluid volume is infused. The blood is collected into blood bags and may be stored for up to twenty-four hours if properly refrigerated. The patient is monitored by anesthesia staff during surgery and by nursing staff after surgery.
Postoperative blood salvage is not usually used for cancer patients.
After the procedure: Following the donation of blood prior to surgery, the donor center staff gives the patient refreshments and observes the patient for any signs of an adverse reaction. During and following the transfusion of autologous blood, anesthesia staff or a nurse monitors the patient for any signs of an adverse reaction.
Risks: The risks of PABD are infusion of the wrong unit of blood, which is very low. The risks of intraoperative blood salvage include reinfusing cancer cells and the reduction of platelets and other clotting factors. The risks of acute normovolemic hemodilution include a reduction of hemoglobin and oxygen-carrying capacity and the dilution of clotting factors.
Results: Ideally, autologous blood transfusion results in a decrease in blood loss and a better surgical outcome.
Bibliography
Adias, Teddy, Zacheus Jeremiah, Emmanuel Uko, and Erhabor Osaro. "Autologous Blood Transfusion—A Review." South African Journal of Surgery 44.3 (2006): 114–18. Print.
Maniatis, Alice, Philippe van der Linden, and Jean-François Hardy. Alternatives to Blood Transfusion in Transfusion Medicine. 2nd ed. Oxford: Wiley, 2011. Print.
McCullough, Jeffrey. Transfusion Medicine. 3rd ed. Oxford: Wiley, 2012. Print.
Shaz, Beth H., Christopher D. Hillyer, Mikhail Roshal, and Charles S. Abrams. Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects. 2nd ed. London: Elsevier, 2013. Print.
Walunj, Ajit, Anna Babb, and Roger Sharpe. "Autologous Blood Transfusion." Continuing Education in Anaesthesia, Critical Care, and Pain 6.5 (2006): 192–96. Print.