Autologous transfusion & its types
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Transcript of Autologous transfusion & its types
Autologous Transfusion
By : Jagjit Khosla
Introduction
Autologous Blood
Transfusion (ABT) means
reinfusion of blood or blood
products taken from the
same patient
Advantages of Autologous Transfusion
Advantages of ABT
Avoiding many
complications of allogenic blood transfusion
Advantages of ABT
NoAcute
hemolytic reaction
Advantages of ABT
No
Allergic or Febrile reaction
Advantages of ABT
No
Transmission of infections
Hepatitis B
AIDS
SyphilisMalaria
Advantages of ABT
Avoiding Immunosuppression by allogenic blood transfusion
Avoiding many complications of allogenic blood transfusion
Advantages of ABT
Patients with
Rare Blood groups are benefitted
Avoiding many complications of allogenic blood transfusion
Avoiding Immunosuppression by allogenic blood transfusion
Advantages of ABT
Conservation of Blood resources
Avoiding many complications of allogenic blood transfusion
Avoiding Immunosuppression by allogenic blood transfusion
Patients with Rare Blood groups are benefitted
Advantages of ABT
Avoiding many complications of allogenic blood transfusion
Avoiding Immunosuppression by allogenic blood transfusion
Patients with Rare Blood groups are benefitted
Conservation of Blood resources
Types of Autologous Blood Transfusion
Types of Autologous Transfusion
Pre – Operative Blood Donation
Acute Normo-volemic Hemodilution
Blood Salvage
Pre – Operative Blood Donation
Pre-Operative Blood Transfusion
Donating blood weeks before any Elective Surgical procedures where significant blood loss is expected which is transfused back during surgery
Person of any age
Patient should be : Weighing >50 Kg Hb > 11gm Hct > 33% Free of Infections No Cardiac Disorders 1 Unit Blood per donation
Pre-Operative Blood Transfusion
STEP 1PATIENT’S CONSENT IS TAKEN
Pre-Operative Blood Transfusion
STEP 2MEDICAL EXAMINATION &
CARDIAC EVALUATION
Pre-Operative Blood Transfusion
STEP 3COLLECTION OF BLOOD
1 Unit blood per donation
1 Donation per week
Last donation atleast 4 days before surgery
Oral Iron therapy started
Pre-Operative Blood Transfusion
STEP 4PROPER LABELLING OF BLOOD
COLLECTION PACKS FOR STORAGE
Autologous
Patient’s Name
Id number
ABO and Rh typing
Pre-Operative Blood Transfusion
STEP 5TRANSFUSING BACK THE BLOOD,
IF NEEDED, DURING SURGERY
Disadvantages of Pre-operative blood donation
Transfusion of Wrong Blood (Clerical Error)
Higher cost
Postoperative anemia
Bacterial contamination of unit
Not suitable for Emergency
Acute Normovolemic Hemodilution
Acute Normovolemic Hemodilution
“Normovolemia” means Maintaining the volume of Blood“Hemodilution” means ↓ no. of RBCs
Immediately before or after induction of anaesthesia,
1-3 units blood removed
Replace with Crystalloid or colloid
Maintains Normovolemia but leads to Hemodilution
Acute Normovolemic Hemodilution
Estimated Blood volume
Whole Blood
Whole Blood
Whole Blood
Crystalloidor Colloid
Normovolemia +
Hemodilution1-3 unit blood removed before start of surgery
Crystalloids or colloids transfused to maintain Normal volume of blood
Transfused during surgery, if needed
Advantages of Acute Normovolemic Hemodilution
No biochemical alterations associated with storage of blood
Platelet function preserved
Hemodilution → ↓Blood Viscosity → Improved Tissue Perfusion
Possible in Emergency surgeries
Less Expensive
Acute Normovolemic Hemodilution
ContraindicationsAnemiaRenal diseasesSevere CAD, severe pulmonary dysfunction
Significant Ischemic heart disease
Complications Myocardial ischemia Cerebral hypoxia
Blood Salvage
Blood Salvage
“Salvage” means saving
Blood is collected from Operative field and draining site and re-infused into the patient after processing
Specialised blood salvage machines are used
Blood Salvage
Anti- Coagulant
Collection Reservoir
Saline Wash
Operative Field
Processor
Waste
Packed RBCs
Waste include most of WBCs, Platelets, clotting factors, and cellular debris
Blood salvage
Contraindications
Gross bacterial contamination in Operative field.
Ascitic or Amniotic cavity
Free tumour tissue
Bowel contents
Blood salvage
Complications
Air embolism or Fat embolism
Hemolysis
Dilutional Coagulopathy
Blood salvage
Applications
Cardio-Vascular surgery
Liver transplantation
Neurosurgery
Ortho & Gynaecological operations