Regional transfusion centre preoperative autologous blood donation programme: the first two years.

OBJECTIVE

To assess the efficacy of a regional autologous blood donation programme.

DESIGN

Clinical and laboratory data were collected and stored prospectively. Transfusion data were collected retrospectively from hospital blood bank records.

SETTING

Northern Region Blood Transfusion Service and 14 hospitals within the Northern Regional Health Authority.

SUBJECTS

505 patients referred for autologous blood donation before elective surgery.

MAIN OUTCOME MEASURES

Patient eligibility, adverse events from donation, autologous blood units provided, and autologous and allogeneic blood units transfused within 10 days of operation.

RESULTS

Of 505 patients referred, 354 donated at least one unit. 78 of 151 referred patients who did not donate were excluded at the autologous clinic, mostly because of anaemia or ischaemic heart disease. In 73 cases the patient, general practitioner, or hospital consultant decided against donation. 363 autologous procedures were undertaken. In 213 (59%) cases all requested units were provided. The most common reasons for incomplete provision were late referral or anaemia. Adverse events accompanied 24 of 928 donations (2.6%). Transfusion data were obtained for 357 of the 363 procedures. 281 donors were transfused; autologous blood only was given to 225, autologous and allogeneic blood was given to 52, and allogeneic blood only was given to four. 648 of 902 (72%) units of autologous blood were transfused. Complete provision of requested autologous units was followed by allogeneic transfusion in 12 of 208 procedures (5.8%). Incomplete provision was followed by allogeneic transfusion in 44 of 149 procedures (30%).

CONCLUSIONS

This study shows the feasibility of a regional autologous transfusion programme. Autologous donors only infrequently received allogeneic transfusion. Patients should be appropriately selected and referred early.