Preoperative autologous blood donation reduces the need for allogeneic blood products: a prospective randomized study

Objective: We sought to assess the efficacy of preoperative autologous blood donation in reducing patient exposure to allogeneic blood products following elective cardiac surgery. Methods: We included 48 patients in a prospective study and randomly assigned them into the control or treatment group. We excluded patients with aortic stenosis, main trunk stenosis and unstable angina. Group A (n = 23; coronary disease n = 21 and valvular disease n = 2) was the control group, and group B (n = 25; coronary disease n = 21, valvular disease n = 4) received preoperative autologous blood donation. All patients had cardiopulmonary bypass surgery, and we processed mediastinal blood with a cell-saver device before reinfusion. All patients received aprotinin, and we reinfused blood shed from the mediastinum postoperatively. Results: No major peri- or postoperative complications occurred. We interrupted preoperative blood donation in 2 patients (8%) because of worsened angina pectoris. The mean time between the first blood donation and surgery was 22.5 (standard deviation [SD] 9.4, range 12‐50) days. In group A, 9 patients (39.1%) were exposed to allogeneic blood products. In group B, 11 patients (47.8%) were exposed to blood products (p = 0.73), and 4 (16%) were exposed to allogeneic blood products (p = 0.036). Conclusion: Preoperative blood donation was completed in 92% of the targeted low-risk population. The procedure significantly reduced exposure to perioperative allogeneic blood products. Objectif : Nous avons cherche a evaluer l’efficacite du prelevement de sang autologue preoperatoire