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Preoperative Autologous and Directed Blood Donation

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Blood Conservation in Cardiac Surgery

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Abstract

Preoperative autologous donation (PAD) is a widely recognized blood conservation strategy that can be defined as the procurement of a specified portion of a patient’s blood preoperatively for later use during the intraoperative and postoperative periods. Its appropriate application leads to a direct reduction in homologous transfusion requirement via a unit-for-unit substitution of autologous for homologous blood. Although there was a gradual increase in the use of PAD in cardiac and general surgery from the early 1960s onward, PAD did not achieve a significant role in perioperative transfusion medicine until the advent of AIDS in the early 1980s and the greater transfusion risk awareness that accompanied this disease. But despite educational efforts aimed at increasing physician-patient awareness of the benefits of PAD, it has remained a relatively underutilized resource. Issues that have hampered its more widespread application in cardiac surgery include those of efficacy, safety, and more recently, cost-effectiveness. But perhaps the most important factor limiting the use of PAD in cardiac surgery is the changing character of the cardiac surgical patient pool. The increasingly acute nature of most cardiac operative interventions in the 1990s, in older and sicker patients, severely limits the preoperative time that is available to optimally perform PAD.

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Authors
  1. Robert E. Helm
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  2. Karl H. Krieger
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Editors and Affiliations

  1. Department of Cardiothoracic Surgery, The New York Hospital-Cornell Medical Center, 10021, New York, NY, USA

    Karl H. Krieger M.D. (Professor and Vice Chairman) & O. Wayne Isom M.D. (Professor and Chairman) (Professor and Vice Chairman) &  (Professor and Chairman)

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Helm, R.E., Krieger, K.H. (1998). Preoperative Autologous and Directed Blood Donation. In: Krieger, K.H., Isom, O.W. (eds) Blood Conservation in Cardiac Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-2180-7_3

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  • DOI: https://doi.org/10.1007/978-1-4612-2180-7_3

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