Preoperative Autologous Blood Donation: Guidelines and Considerations

Guidelines for Preoperative Autologous Blood Donation

Autologous blood donation involves collecting a patient's own blood before surgery for potential use during the procedure. This process helps minimize risks associated with receiving blood from others.

Blood Loss Thresholds Requiring Transfusion

In healthy adults, blood transfusion is typically considered if surgical bleeding exceeds 30% of the body's total blood volume or if hemoglobin levels drop below 7g/dL. Clinical decisions also factor in the patient's overall health and any underlying systemic conditions.

Blood Loss in Jaw and Bone Surgery

The amount of blood loss during jaw and bone cutting procedures varies based on the surgery's complexity and duration. Advances in anesthesia and surgical techniques have reduced instances where bleeding exceeds 30% of total blood volume to less than 5% in recent years.

Timing and Volume for Autologous Donation

Autologous blood donation should occur 7 to 30 days before surgery, with 250 to 500cc of blood collected and stored at a blood bank. This blood can be administered up to 30 minutes before the procedure ends.

Pros and Cons of Autologous Blood Donation

Advantages:

• Reduces the need for allogeneic blood transfusions.
• Lowers infection risks linked to donor blood.
• Avoids immune reactions associated with allogeneic transfusions.

Disadvantages:

• Involves multiple steps for donation and storage.
• Carries risks of human error during handling and processing.

Circumstances Preventing Autologous Donation

Autologous blood donation is not suitable under the following conditions:

1. Age over 65 years.
2. Weight less than 45 kg.
3. Acute infections or bacteremia, indicated by fever or elevated white blood cell counts.
4. Hemoglobin levels below 11g/dL.
5. Other systemic diseases or bleeding tendencies deemed unsuitable by a physician.

Recommended Scenarios for Autologous Donation

Autologous donation is advised in these situations:

1. Rare blood types where compatible products are hard to obtain.
2. History of immune responses to allogeneic transfusions.
3. Significant psychological distress or anxiety about receiving donor blood.