Aftab Yunus, Ambreen Khan, Ishtiaq Sarwar, Rashid Ali.
Autologous Blood Transfusion in Cardiac Surgery Reduces Donor Blood Requirement.
Pak J Med Health Sci Jan ;6(2):292-4.

Aim: To see if use of autologous blood transfusions (ABT) compared with no autologous blood transfusion reduces donor blood transfusions in patients undergoing cardiac surgery in a public hospital in Pakistan. Design: Experimental study. Place and duration of study: Cardiac Surgery Department, Mayo Hospital/K. E. Medical University Lahore. Duration of study was 18 months from January 2006 to October 2007. Material and methods: A total of 200 consecutive patients undergoing open-heart surgery were included in the study. These were all adult patients with preop haemoglobin of ≥12.5gram/100ml operated by a single group of surgeons. The patients who were reexplored for bleeding or had complicated postop course or who did not survive the operation were excluded. All of the pump blood after cessation of cardiopulmonary bypass was transfused to the pt. Patients were divided into two groups with alternate patient going into respective groups. Group A (100 pts.) in whom one unit of blood was withdrawn after induction. This unit of blood was transfused to the pt as autologous blood after cessation of cardiopulmonary bypass, when the effects of heparin were being reversed by Protamine. Group B (100 pts.) in whom no blood was taken to be used later as autologous blood. Intra & postop allogeneic blood transfusions were given based upon strict transfusion criterion. Results: Only 16% pts in group A required postop whole blood transfusion compared to 33% pts in group B (p-value=0.017) indicating significantly lower need of donor blood transfusion in group A. However, there was no statistically significant difference in other recorded variables such as preop haemoglobin (14.58±1.56 vs 14.22±1.10, p-value:0.083), postop haemoglobin (10.40±1.72vs 10.47±1.53, p-value:0.781), bypass time (65.79±21.57vs. 67.22±24.08; p-value:0.714) and cross-clamp time (39.74±17.34 vs 41.46±16.86;p-value:0.551) when group A was compared to group B respectively. Conclusion: Autologous blood transfusion is a highly effective method to reduce the need for periop donor blood transfusion in pts undergoing cardiac surgery. This practice could be of enormous value in pts undergoing cardiac surgery in the developing world considering the context of population with high prevalence of hepatitis B&C and other blood transfusion related infectious diseases.

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