Yamamuro M, Kudou K, Hosoda Y, Nukariya M, Sasaguri S, Watanabe M, Yuasa S
Department of Thoracic Surgery, Juntendo University, Tokyo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Aug;42(8):1123-31.
Since April 1989, we have been using autologous blood donation in order to avoid homologous blood transfusion as much as possible. To determine the factors which influence the necessity for homologous blood transfusion as well as autologous blood donation. Of them 77.6% (group 1) required autologous blood only, but others needed homologous blood transfusion as well as autologous blood. Using an invert analysis, preoperative factors that showed significant differences were age, body weight, number of autologous blood donations, amount of donated autologous blood, preoperative Hb and Ht. Among operative factors, aortic cross clamping time, cardiopulmonary bypass time, amount of concentrated blood from CPB circuit, amount of transfused autologous blood and amount of drainage demonstrated significant differences between groups. Univariately significant factors were studied by multivariate discriminant analysis. Total amount of drainage proved to be the best contributor of non-homologous blood transfusion surgery, followed by preoperative Hb, body weight, amount of concentrated blood from CPB circuit and amount of donated autologous blood in order of contribution Understanding these factors, homologous blood transfusion requirement may be greatly reduced. This is thought to be the largest series of autologous blood donation in Japan.
自1989年4月以来，我们一直在使用自体输血，以尽可能避免异体输血。为了确定影响异体输血必要性以及自体输血的因素。其中77.6%（第1组）仅需要自体血，但其他患者既需要异体输血也需要自体输血。通过反向分析，术前显示出显著差异的因素有年龄、体重、自体输血次数、自体献血量、术前血红蛋白（Hb）和血细胞比容（Ht）。在手术因素中，主动脉阻断时间、体外循环时间、体外循环回路中的浓缩血量、自体输血输血量和引流量在两组之间显示出显著差异。通过多变量判别分析研究单变量显著因素。引流量总量被证明是无异体输血手术的最佳贡献因素，其次是术前Hb、体重、体外循环回路中的浓缩血量和自体献血量，按贡献顺序排列。了解这些因素后，异体输血需求可能会大大降低。这被认为是日本最大规模的自体输血系列研究。
