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