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
Specifically that pre-deposit may not be sufficient to replace blood loss
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.
Meta-Analysis 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:
Rare blood groups where unable to obtain allogeneic blood
Children with scoliosis
Patients at serious psychiatric risk if allogeneic transfusion is thought likely to cover their elective surgery
Patients who do not consent to allogeneic transfusion but would consent to PAD
Requirements
Competent to give informed consent
Sufficient time between collection date and surgery, approx. 5 weeks
The planned Surgical intervention would usually be expected to need allogeneic blood
Men Hb 110-145, Women 130-145
Age >10 years old
Blood borne virus negative
Use of empirical iron or erythropoietin is not recommended