One autologous Donating blood is when you draw or collect blood before or during a scheduled surgery so that it can be returned to you when you need it. When this happens, it’s called an autotransfusion.
Autologous blood donations are often recommended because they reduce your risk of acquiring blood-borne infections from blood donations from others and ensure an adequate blood supply for you when blood resources are scarce.
This article explains the types of autologous blood donation, when it can be recommended, the risks and benefits, and expected outcomes.
Knowledge about blood transfusion
Types of Autologous Blood Donation
There are four types of autologous blood donation/transfusion procedures:
- Preoperative autologous donation (PAD) is the process of collecting blood several weeks before surgery. It is then stored in a blood bank and infused back to the donor when needed.
- acute isovolumic hemodilution (ANH) involves the removal of blood immediately after surgical anesthesia. Then, an equal amount of intravenous fluid is returned to the body to maintain normal blood volume and blood pressure.
- Intraoperative cell retrieval is a technique in which blood lost during surgery is immediately returned to the circulation using cell protection machinery. Not only does the machine filter debris from the blood, it also adds an anticoagulant, a drug that prevents blood clotting.
- Postoperative cell recovery involves the collection of blood lost during surgery through wound drains. Blood is processed in the same way as intraoperative cell recovery, but reinfused after surgery rather than during surgery.
Why patients choose bloodless surgery and blood preservation
when can it be done
Your doctor may recommend autologous blood donation/transfusion based on the type of surgery you undergo.
Other times, people concerned about the risks of blood transfusions may opt for this.
If you may need a blood transfusion during or after surgery, your surgeon may recommend that you donate blood in advance. Cell rescue transfusions can also be performed in emergency situations.
Autologous blood transfusions are usually considered when your doctor predicts that you may lose 20% or more of your blood during surgery. In addition to major cancer surgery, such as removal of part of the lung, major joint replacement surgery, vascular surgery, or cardiothoracic surgery often requires autologous blood transfusions.
Sometimes as many as 10 units of packed red blood cells are needed – the equivalent of a person’s full blood volume. When it happens within 24 hours, it’s considered a massive blood transfusion.
Autologous blood donation may also be recommended to relieve pressure on the community’s blood supply. These donations can be used in conjunction with allogeneic donations (donations from other people).
If blood loss is expected to be less than 10% during surgery, autologous blood donation before surgery can usually be avoided by most people.
Autologous blood transfusions can reduce the risk of allergic or autoimmune reactions that can occur in rare cases with allogeneic blood transfusions. This includes hemolytic transfusion reactions, in which the immune system attacks and destroys donated blood cells.
Your surgeon may raise this possibility if your health history warrants it. However, the choice to proceed with autologous donation/transfusion is ultimately personal.
You can also ask for autologous blood transfusions if you are concerned about blood-borne infections such as hepatitis C or HIV. However, strict blood screening protocols in the United States make elective donation/transfusion for this purpose unnecessary and extremely rare.
If you’re still concerned, donating and receiving your own blood can give you peace of mind.
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advantages and disadvantages
Autologous blood donation and transfusion have both actual and perceived benefits, but also risks.
Reduce the risk of blood-borne infections
Reduce the risk of allergic or hemolytic transfusion reactions
Safer for people with rare blood types (A-, B-, B+, AB-, AB+, O-)
Safer for people with multiple autoimmune diseases
Reduced demand for community blood supply
May be accepted by Jehovah’s Witnesses and other religious groups with blood donation rules
more expensive than donating blood from someone else
Donation time is inconvenient
Unused blood cannot be donated to others, so it is discarded
Risk of anemia (lack of healthy red blood cells) and heart complications after donation
Risk of bacterial infection if blood is not stored properly
Blood transfusion needs may increase after donation due to depletion of blood in the body
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Risks and Complications
There are some potentially serious complications associated with different types of autologous blood donation/transfusion.
donation before surgery
The risks of preoperative autologous blood donation are no different from those of any other blood donation.
That being said, some medical conditions opt for autologous blood donation due to the risk of anemia.
Preoperative autologous donation is also not used for people with current heart disease and other conditions that may pose other risks. These include:
- active epilepsy
- Heart attack or stroke within six months
- Left coronary artery disease (high grade)
- sepsis or bacteremia
- Scheduled Aortic Aneurysm Surgery
- symptomatic heart failure
- uncontrolled high blood pressure
- unstable angina
Preoperative autologous donation is also not recommended for pregnant women unless the benefits outweigh the risks. For example, if a person’s condition puts them at risk for major bleeding after birth, they may be guaranteed.
With intraoperative or postoperative cell recovery, recovered blood undergoes significant changes as it is washed in preparation for reinfusion.
This process upsets the balance of electrolytes (chemicals that conduct electricity) and reduces platelets (blood cells that control blood clotting).
These combine with released hemoglobin, a protein in red blood cells, to trigger a serious condition called salvage blood syndrome, in which abnormal clots form in blood vessels.
When the lungs or kidneys are involved, salvage blood syndrome can lead to severe lung damage and acute renal failure.
acute isovolemic hemodilution
and acute isovolemic hemodilutiona sudden decrease in red blood cell volume (hematocrit) may cause circulatory shock.
This is when reduced blood flow can damage body tissue. It can even cause heart attacks in people with underlying heart conditions.
Choose bloodless surgery
what to expect
If you choose to have an autologous blood transfusion, your clinician will usually draw blood for you before surgery.
There are no age or weight restrictions on autologous blood transfusion. However, you should carefully weigh the benefits and risks before proceeding.
Not everyone is suitable for donating blood, so your healthcare provider will help you decide if it is right for you. Some of the things they will consider include:
- Whether blood transfusions are possible (eg, major orthopedic surgery, vascular surgery, or heart surgery)
- if your overall health is good
- Community supply may be insufficient if you have a rare blood type
- You are more likely to have adverse reactions to donating blood if you have an autoimmune disease
The process of donating autologous blood is no different from regular blood donation, except that your healthcare provider may prescribe iron supplements to boost red blood cell production before you donate blood.
Autologous donation requires a signed medical order and is done by appointment.
Upon arrival, a brief medical history will be taken. also:
- Clinicians will measure your pulse, blood pressure, and temperature.
- They will do a finger blood test to check your hematocrit and determine if you are anemic.
- If clinical symptoms are good, blood will be drawn from a vein.
- After that, you will have a snack and rest for 10 to 15 minutes before going home.
Determine the donation amount
Your surgeon will determine how much blood you should donate based on your weight. The maximum donation amount is calculated at 10 milliliters per kilogram of body weight (mL/kg).
So, for example, a person weighing 110 pounds (50 kilograms) can donate up to 500 milliliters (0.5 liters) at a time.
You can donate more than once a week, but the last donation should be made no less than 72 hours before surgery. This gives your blood volume time to return to normal.
Blood can be refrigerated for up to 42 days. After that time, the blood bank will process it. Blood banks can freeze blood, but autologous donation is not recommended because freezing can damage blood cells and alter blood composition.
How to find your blood type
Autologous blood donation can be done before surgery so that you can receive your own blood if you need a blood transfusion during surgery. You may also choose to do so if you want to avoid certain risks of blood transfusions, such as blood-borne infections, allergies, or autoimmune reactions.
Donating blood is generally considered safe. However, people with certain medical conditions are not suitable for self-donating blood. These include people with certain heart conditions and epilepsy.
It is important to discuss the risks and benefits of autologous blood transfusion with your surgeon. This is especially true if you are donating blood to allay your fears of blood-borne infection. However, in some cases, the risks to your health may outweigh the perceived benefits.
Also, if your insurance company doesn’t think it’s necessary, they may deny your claim. Therefore, before you schedule a donation, consider the cost of an autologous blood transfusion and confirm that your insurance will cover the procedure.