Goldman Mindy, Savard Renée, Long Anne, Gélinas Stéphanie, Germain Marc
Héma-Québec, Montréal, Canada.
Transfusion. 2002 Jul;42(7):819-23. doi: 10.1046/j.1537-2995.2002.00132.x.
Preoperative autologous blood donation (PABD) has been shown to decrease allogeneic blood transfusion requirements in major elective surgery. Changes in transfusion practice motivated an examination of blood use from 1993 to 2000 of patients participating in the Héma-Québec PABD program.
Blood donation and transfusion, type of surgery, and demographic characteristics were prospectively entered into a computer database for patients participating in the Héma-Québec PABD program.
Autologous donations represented from 0.8 to 2 percent of total blood collections and have declined by 26 percent after peaking in 1995. The mean number of units collected per patient declined, as did the number of units transfused per patient and the utilization rate. For radical prostatectomy, knee replacement surgery, hip replacement surgery, and scoliosis, utilization rates were 72, 60, 83, and 78 percent in 1993 compared with 50, 50, 58, and 58 percent in 2000, respectively. In 2000, 18 percent of patients were receiving a 1-unit autologous transfusion. Depending on the surgical procedure, 85 to 95 percent of patients avoided allogeneic transfusion; this did not change significantly from 1993 to 2000.
Patients participating in the PABD program successfully avoided allogeneic transfusion in over 85 percent of cases. However, declining utilization rates and frequent 1-unit transfusions demonstrate the decreasing utility of PABD over time.
术前自体血捐献（PABD）已被证明可减少大型择期手术中异体输血的需求。输血实践的变化促使对1993年至2000年参与魁北克血液中心PABD项目的患者的用血情况进行调查。
前瞻性地将参与魁北克血液中心PABD项目患者的献血和输血情况、手术类型及人口统计学特征录入计算机数据库。
自体献血占总采血量的0.8%至2%，在1995年达到峰值后下降了26%。每位患者采集的平均单位数、每位患者输注的单位数及利用率均有所下降。对于根治性前列腺切除术、膝关节置换术、髋关节置换术和脊柱侧弯手术，1993年的利用率分别为72%、60%、83%和78%，而2000年分别为50%、50%、58%和58%。2000年，18%的患者接受了1单位自体输血。根据手术方式，85%至95%的患者避免了异体输血；1993年至2000年这一比例无显著变化。
参与PABD项目的患者在超过85%的情况下成功避免了异体输血。然而，利用率下降和频繁的1单位输血表明，随着时间的推移，PABD的效用在降低。
