Predeposit Autologous Blood Donation (PAD) (BSH 2007)

 

Intro

-       Fallen out of favour compared to 1990’s

-       Covered by all the same rules, regulations and practices as allogeneic blood donation

-       Written consent from patient required

o   Specifically than pre-deposit may not be sufficient to replace blood loss

o   Risk remains of blood transfusion errors

 

Deferral Criteria for PAD

-       Serious cardiac disease

-       Acute bacterial infection

 

Contraindications to PAD

-       Hb <110g/l

 

Minimum Testing Requirements

-       ABO D Group

-       Hep B/C and HIV

 

Trial Data

-       No RCT from UK

-       2002 in US – 96 patients for elective hip surgery – autologous donor arm were actually more anaemic post-op than non-donors. No other difference in outcomes. None of 96 patients received an allogeneic transfusion.

-       Systemic Review 1998 – concluded minimal benefit in reducing need for allogeneic blood but that PAD still carries some of the risks of transfusion.

 

Recommendations

 

Whole blood

-       Not recommended

-       Limited indications are:

o   Rare blood groups where unable to obtain allogeneic blood

o   Children with scoliosis

o   Patients at serious psychiatric risk if allogeneic transfusion is thought likely to cover their elective surgery

o   Patients who do not consent to allogeneic transfusion but would consent to PAD

-       Requirements

o   Competent to give informed consent

o   Sufficient time between collection date and surgery, approx. 5 weeks

o   The planned Surgical intervention would usually be expected to need allogeneic blood

o   Men Hb 110-145, Women 130-145

o   Age >10 years old

o   Blood borne virus negative

-       Use of empirical iron or erythropoietin is not recommended