AUTOLOGOUS BLOOD TRANSFUSION

Definition: – Autologous blood transfusion is the collection of blood from a single patient and re-transfusion back to the same patient.

Why Autologous Blood Transfusion? (Advantages)

  1. To avoid transmission of viral infection like Hepatitis, HIV, HTLV viruses.
  2. To avoid transmission of variant Creutzfeldt -Jakob disease(VCJD). There is no effective screening test.
  3. Allogenic donor blood is becoming increasingly costly.
  4. As demand for blood is out stripping donation, so there is real social & economic pressure to increase the proportion of blood transfused by autologous transfusion.

Techniques    

  1. Cell Salvage: -Blood is collected from suction, surgical drains or both and re-transfused back to patient after filtration and washing. Cell salvage is most important and commonly used technique. It is widely used in cardiothoracic, vascular, orthopedic, neuro and transplantation surgery. This technique should be used when blood loss is expected to be > 1 liter.
  2. PreOperative Autologous Donation (P.A.D.): – It is widely used in developed world including UK & US. This process starts. 3-4 weeks prior to surgery. It allows to collect 3-4 units of blood. Oral or IV iron supplementation may be required to maintain erythropoiesis. Last donation should take place 48-72 hours before surgery to allow for equilibration of blood volume. The blood is collected into citrated phosphonate dextrose blood bags and stored in the blood bank. Blood should be clearly labelled to identify it from allogenic units. At the time of surgery, pre-donated blood is drawn from the blood bank.
  3. Acute Normovolaemic Hemodilution (A.N.H.):- A.N. H. is performed in the anaesthetic room shortly before or after induction of anasthesia. 15 to 20 ml/kg of blood is collected prior to surgery. Blood volume is restored with crystalloid or colloid. Collected blood is labelled and kept in the operating room without refrigeration and transfused back to patient when required.

Contra indication for P.A.D & A.N.H:

  • Preexisting anaemia.
  • Heart disease.
  • Uncontrolled Hypertension.
  • Extremes of age.

Conclusion :

In short it can be concluded that in majority of patient, patient itself is its own blood bank.

 

Written By: Dr. Ishwar Article

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