Goodnough L T
Medicine, Pathology and Immunology, Division of Laboratory Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
Zentralbl Chir. 2003 Jun;128(6):462-7. doi: 10.1055/s-2003-40618.
Autologous blood procurement remains in evolution. Interest in preoperative autologous blood donation (PAD) increased substantially in the 1980's due to the recognition that HIV was transmissible by blood. Concomitant with increased blood safety, however, PAD activity has declined approximately 40% since 1992. Reasons for this decline are unclear; patients may feel more comfortable with issues regarding blood safety, but associated costs and discard rates of up to 50% of blood units are other important factors. An alternate strategy is acute normovolemic hemodilution (ANH), which has the advantages of lower costs along with no wastage of blood units. A further advantage is that since ANH units never leave the patient's bedside, there is no possibility of an administrative error that could lead to ABO-related hemolysis (as could occur with PAD units stored in the blood bank). Concerns regarding the adequacy of national blood inventories may restimulate interest in autologous blood procurement, independent of issues regarding blood risks or costs.
自体血液采集仍在不断发展。由于认识到艾滋病毒可通过血液传播，20世纪80年代对术前自体血液捐献（PAD）的兴趣大幅增加。然而，随着血液安全性的提高，自1992年以来，PAD活动已下降了约40%。下降的原因尚不清楚；患者可能对血液安全问题感觉更放心，但相关成本以及高达50%的血液单位废弃率是其他重要因素。另一种策略是急性等容血液稀释（ANH），其优点是成本较低且无血液单位浪费。另一个优点是，由于ANH的血液单位从未离开患者床边，不存在可能导致ABO相关溶血的管理错误（如储存在血库中的PAD血液单位可能发生的情况）。对国家血液库存充足性的担忧可能会重新激发对自体血液采集的兴趣，而与血液风险或成本问题无关。
