Intraoperative predonation contributes to blood saving

• Published in: The Annals of thoracic surgery Vol. 56; no. 4; pp. 893 - 898
• Main Authors: Schönberger, Jacques P.A.M., Bredée, Johan J., Tjian, Dave, Everts, Peter A.M., Wildevuur, Charles R.H.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-10-1993; Elsevier Science
• Subjects: Biological and medical sciences; Blood Loss, Surgical - prevention & control; Blood Transfusion, Autologous; Female; Hemostasis, Surgical - methods; Humans; Intraoperative Period; Male; Medical sciences; Middle Aged; Myocardial Revascularization - methods; Platelet Count; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Human; Postoperative; Cardiovascular disease; Intraoperative; Coronary heart disease; Recovery; Cardiopulmonary bypass; Prevention; Reperfusion; Surgery; Blood loss; Fresh blood; Complication; Technique
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/0003-4975(93)90351-H

The merits of reinfusing prebypass-removed autologous blood (intraoperative predonation) to salvage blood and improve postoperative hemostasis are still debated, specifically for patients at a higher risk for bleeding. To evaluate the effect of intraoperative predonation on the platelet count, blood hemoglobin content, and blood saving postoperatively, we retrospectively studied 100 matching patients. All patients underwent internal mammary artery bypass surgery resulting in a considerable blood loss postoperatively. Intraoperative predonation (800 ml), reinfusion of the residual volume of the extracorporeal circuit, autotransfusion of shed blood, and acceptance of normovolemic anemia postoperatively was the approach adopted in 50 patients (group 1). A similar blood salvage program, excluding intraoperative predonation, was carried out in the other 50 patients (group 2), and these served as the control group. The platelet counts and blood hemoglobin content were significantly higher postoperatively (
p < 0.01) in the predonated patients than in the control patients. However, the net blood loss, the amount of retransfused shed blood, and the blood requirements postoperatively were significantly less (
p < 0.01) in the predonated patients than in the control patients, whereas 65% of the predonated patients versus 10% of the control patients did not need any donor blood products. In conclusion, predonation reduces the postoperative blood loss and thereby importantly ameliorates the blood-saving effect of a blood salvage program after IMA procedures.