Autologous blood use in reduction mammaplasty: is it justified?

A study was undertaken to evaluate the current use of autologous blood predonation within 3 weeks of reduction mammaplasty in our institution. A retrospective study of 153 consecutive patients undergoing reduction mammaplasty between April of 1987 and October of 1992 was analyzed. Nine patients were excluded because of inadequate data, leaving 81 patients in the autologous blood predonation study group and 63 patients in the control group. The two groups were similar with regard to age, preintervention hemoglobin levels, technique of reduction mammaplasty, average number of grams excised per side, estimated blood loss, and duration of hospital stay. Those in the study group, despite preoperative iron therapy initiated just prior to the time of autologous blood donation, had significantly lower preoperative hemoglobin levels (p < 0.001). Seventy-two percent of those patients who donated blood preoperatively received all their blood intraoperatively or within 1 day of surgery. Eleven percent received 1 of their 2 units donated, and the remaining 17 percent were not transfused. Despite 83 percent of the study group patients receiving all or some of their predonated blood, their postoperative hemoglobin levels were not significantly different from those of the control group. We concluded that under our current program, autologous blood predonation for reduction mammaplasty is not beneficial to the patient in the immediate perioperative period.