PRESENTATION ON PRESENTATION ON AUTOLOGOUS TRANSFUSIONAUTOLOGOUS TRANSFUSION

Presented by Humaira ShafaqPresented by Humaira Shafaq

B-S Medical TechnologyB-S Medical Technology

Liaquat National HospitalLiaquat National Hospital

ContentsContents IntroductionIntroduction

CategoriesCategories

Advantages and DisadvantagesAdvantages and Disadvantages

Indications and contraindicationsIndications and contraindications

Preoperative Blood collectionPreoperative Blood collection

Acute Normovolemic HemodilutionAcute Normovolemic Hemodilution

Intra and Post-operative Blood collectionIntra and Post-operative Blood collection

Definition Definition

Autologous blood donation is Autologous blood donation is the process of donating one's the process of donating one's own blood prior to an elective own blood prior to an elective surgical or medical procedure surgical or medical procedure to avoid or reduce the need to avoid or reduce the need for an allogeneic blood for an allogeneic blood transfusion transfusion (from a volunteer (from a volunteer blood donor). blood donor).

Autologous Blood donation Autologous Blood donation InvolveInvolve

A pre-autologous interview will be conducted A pre-autologous interview will be conducted at the donor center prior to your first at the donor center prior to your first collection.collection.

The procedure includeThe procedure include:: donor consent.donor consent. informed consent.informed consent. donor declaration forms.donor declaration forms. Screening bloods will be collected and the Screening bloods will be collected and the

prescription of iron and vitamin tablets will prescription of iron and vitamin tablets will normally be discussed. normally be discussed.

AdvantagesAdvantages

The patient is assured that the blood is an exact match to his or her The patient is assured that the blood is an exact match to his or her blood type, thereby avoiding transfusion reaction. blood type, thereby avoiding transfusion reaction.

There is no risk of inadvertently transmitting infectious agentsThere is no risk of inadvertently transmitting infectious agents..

Autologous blood donations supplement the community blood Autologous blood donations supplement the community blood supply. supply.

The process of donating blood promotes blood cell production by The process of donating blood promotes blood cell production by bone marrowbone marrow..

The patient is often reassured by the knowledge that his or her own The patient is often reassured by the knowledge that his or her own blood will be used if a blood transfusion becomes necessary.blood will be used if a blood transfusion becomes necessary.

DisadvantagesDisadvantages Contamination of autologous blood with infectious agents is possible Contamination of autologous blood with infectious agents is possible

during the donation process. during the donation process.

There is a possibility that a patient's blood will be mislabeled or that There is a possibility that a patient's blood will be mislabeled or that allogeneic blood will be inadvertently transfused.allogeneic blood will be inadvertently transfused.

Autologous blood donation costs more to process and store.Autologous blood donation costs more to process and store. Blood may be transfused unnecessarily because an autologous Blood may be transfused unnecessarily because an autologous

blood supply exists. blood supply exists.

Unused units of autologous blood are usually disposed of; Unused units of autologous blood are usually disposed of; approximately 44% of autologous donations remain unused after approximately 44% of autologous donations remain unused after surgery. surgery.

Person Qualified to be Person Qualified to be Autologous DonorAutologous Donor

Those who are not anemic.Those who are not anemic.

Those who have no medical condition that could cause Those who have no medical condition that could cause problems during or after the Blood donation process.problems during or after the Blood donation process.

Children weighing over 65 pounds.Children weighing over 65 pounds.

Those who are having planned surgery that routinely Those who are having planned surgery that routinely requires a transfusion (except in cases where long term requires a transfusion (except in cases where long term storage is desired).storage is desired).

Side effect of Autologous Side effect of Autologous DonationDonation

Some people feel light headed or dizzy during or Some people feel light headed or dizzy during or after the donation; fainting can occur.after the donation; fainting can occur.

Sometimes a bruise may appear around the place Sometimes a bruise may appear around the place where the needle was inserted and the area may where the needle was inserted and the area may be sore to touch for some time. be sore to touch for some time.

Patient may feel fatigued for sometime.Patient may feel fatigued for sometime.

vasovagal reaction.vasovagal reaction.

Types of Autologous Blood DonationTypes of Autologous Blood Donation

Preoperative autologous BloodPreoperative autologous Blood

Acute normo-volemic hemodilution (ANH)Acute normo-volemic hemodilution (ANH)..

Intraoperative hemodilution.Intraoperative hemodilution.

Intraoperative Blood salvageIntraoperative Blood salvage..

Preoperative Autologous BloodPreoperative Autologous Blood

Blood donation, transfusion and Blood donation, transfusion and storage (PABD) units of Blood are storage (PABD) units of Blood are drawn from a patient usually drawn from a patient usually starting (in the short term case) starting (in the short term case) three to five weeks before an three to five weeks before an elective surgical procedure and elective surgical procedure and stored for transfusion at the time of stored for transfusion at the time of the surgery. the surgery.

Intra operative Blood salvageIntra operative Blood salvage

Blood is salvaged from the Blood is salvaged from the surgical area during the surgical area during the operation for re-infusion operation for re-infusion during or after the surgical during or after the surgical procedure.procedure.

Postoperative Blood salvagePostoperative Blood salvage

Blood is collected after the Blood is collected after the surgical procedure is complete surgical procedure is complete by drainage of the operative by drainage of the operative area and re-infused. area and re-infused.

Acute normo-volemic Acute normo-volemic hemodilution (ANH)hemodilution (ANH)..

Blood is collected at the start Blood is collected at the start of surgery and the fluid of surgery and the fluid volume lost is replaced with volume lost is replaced with appropriate IV solutions, and appropriate IV solutions, and then finally, stored Blood is then finally, stored Blood is reinfused after surgery. reinfused after surgery.

Indications for Autologous Indications for Autologous TransfusionTransfusion

Major Orthopedic surgeries.Major Orthopedic surgeries. Cardiovascular surgeries.Cardiovascular surgeries. Obstetric surgeries (hysterectomy, ovarian Obstetric surgeries (hysterectomy, ovarian

tumour etc.)tumour etc.) Radical prostectomy, mastectomy.Radical prostectomy, mastectomy. Gatro-surgery.Gatro-surgery. Blood collected in thoracic or abdominal Blood collected in thoracic or abdominal

cavity due to organ rupture or surgical cavity due to organ rupture or surgical procedures.procedures.

ContraindicationsContraindications

Evidence of infection and risk of Evidence of infection and risk of bacteremia.bacteremia.

Unstable angina.Unstable angina. Active seizure disorder.Active seizure disorder. Myocardial infarction or CV accidents.Myocardial infarction or CV accidents. Significant cardiac or pulmonary disease.Significant cardiac or pulmonary disease. Cyanotic heart disease.Cyanotic heart disease. Uncontrolled hypertension.Uncontrolled hypertension. Malignant disease.Malignant disease.

After care for Autologous Blood After care for Autologous Blood DonorsDonors

Individuals who donate blood are generally given Individuals who donate blood are generally given fluids and/or light refreshments to prevent possible fluids and/or light refreshments to prevent possible side effects such as dizziness and nausea. side effects such as dizziness and nausea.

Iron supplements may be prescribed to prevent or Iron supplements may be prescribed to prevent or treat anemiatreat anemia

Storage of bloodStorage of blood

ABO and Rh typing on labeled samples of patient.ABO and Rh typing on labeled samples of patient.

Units should have ‘green label’ with patient name & Units should have ‘green label’ with patient name & number & marked ‘FOR AUTOLOGOUS USE ONLY’number & marked ‘FOR AUTOLOGOUS USE ONLY’

Longest possible shelf life for collected units increases Longest possible shelf life for collected units increases flexibility for the patient and allows time for flexibility for the patient and allows time for restoration of red cell mass, between collection and restoration of red cell mass, between collection and surgery. Liquid storage is feasible for 6 weeks. For surgery. Liquid storage is feasible for 6 weeks. For longer duration, the red have to be frozen.longer duration, the red have to be frozen.

Special Autologous label may be used with numbering Special Autologous label may be used with numbering to ensure that oldest units are issued firstto ensure that oldest units are issued first..

Autologous Sticker

Morbidity and mortality rates Morbidity and mortality rates

One study found the risk of a complication One study found the risk of a complication requiring hospitalization to be one in requiring hospitalization to be one in approximately 17,000 among autologous approximately 17,000 among autologous blood donorsblood donors..

There is a higher chance of a vasovagal There is a higher chance of a vasovagal reaction with autologous blood donation reaction with autologous blood donation than with allogeneic blood donatiothan with allogeneic blood donation.n.

AlternativesAlternatives

Allogeneic blood is a more commonly used Allogeneic blood is a more commonly used alternative to autologous blood.alternative to autologous blood.

Patients may also choose to have blood Patients may also choose to have blood donated by family or friends, a process donated by family or friends, a process called directed cdonationcalled directed cdonation..