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Autologus Blood Transfusion

About Dr Amer Hussain Agha

An autologus donation is the donation of blood for the donor’s own use.

Indications:
1) To prevent transfusion transmitted diseases.
2) To provide stock for the rare blood groups.
3) To prevent the alloimmunization in the recipient.
4) To prevent the patient from severe transfusion reactions.
5) To permit transfusion availability to patients whose religious beliefs prohibit blood transfusion.
6) To maintain blood supply in remote areas.
7) To improve transfusion practice by forcing the physicians to review transfusion requirements.

Classification:
There are four broad classifications for autologus procedures.
A) Preoperative or predeposit.
B) Perioperative hemodilution.
C) Intraoperative salvage.
D) Postoperative salvage.

A) Preoperative or Predeposit ;
The donation of one or more units of blood by a donor for his or her own use for some planned future need such as pending surgery. It is possible to collect upto 5 units on weekly basis with storage life of 35 days at 4°C. 
There is another technique for autologus donation, known as “LEAPFROG” technique.

B) Perioperative or Isovolaemic hemodilution;
The process of removing blood from a surgical patient immediately prior to the beginning of the surgical procedure,(with volume replacement by colloid or crystalloid solutions) to be re infused at the end of the surgical procedure.

C) Intraoperative blood salvage;
The recovery of lost blood containning fluid at the site of operation, is collected, washed and reinfused using a mechanical “cell 
saver”. But it is contraindicated in bowel and pencreatic surgery and surgery for malignancy.

D) Postoperative blood salvage (mediastinal drainage);
The salvage of blood containing fluid from chest tube drainage postoperatively.

Advantages;
i) Abolishes transfusion related risks of infection and alloimmunization.
ii) Provides useful source of blood for patients with rare groups or with antibodies against high frequency red cell antigens.
iii) Possible to get compatible blood at a short notice.
iv) Isovolaemic hemodilution improves the quality of blood by reducing the viscosity.
v) Conserves supplies of standard donor blood.

Disadvantages;
i) Relatively expensive and time consuming and require careful organization.
ii) Requires advancce planning with cooperation of surgeons to confirm definite dates at least one month in advance of surgery.
iii) Applicable to a limited population.
iv) Appropriate for relatively few surgical procedures.

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