Preoperative Autologous Blood Donation in Cardiac Surgery

SUMMARY Autologous blood donation is one of the oldest methods to avoid allogeneic blood tran‐fusion. This method has repeatedly shown to be an effective practice to reduce the exposure of patients to allogeneic blood in cardiac surgery. However, during recent years, this method has been criticized increasingly, mostly for economic reasons. The objective of this overview is to assess the role of autologous blood predonation in cardiac surgery. We evaluated our results in 8235 cardiac surgical patients, of which 18% (1512 of 8235) underwent autologous blood donation. To avoid a selection bias, patients were stratified for preoperative risk score. Of all patients undergoing autologous blood donation 16% received allogeneic blood while 57% of the patients without predonation received transfusion (p < 0.05). Patients without predonation received 1.67 ± 2.8 (mean ± SD) allogeneic units, patients in the autologous group 0.39 ± 1.25 (p < 0.05). Patients with predonation received a higher total number of any transfusion (autologous and allogeneic) compared to patients without predonation (2.39 ± 3.4 vs. 1.79 ± 3.7, p < 0.05). Elective cardiac surgery offers ideal conditions for autologous blood donation mainly because of the high probability of transfusion. In our hands, it was a cost‐effective method to reduce allogeneic blood transfusion. Based on our results, we conclude, that autologous predonation still remains a promising and cost‐effective alternative in the attempt to reduce allogeneic blood transfusion in elective cardiac surgery.