Blood conservation in cardiac operations

Efficacy and safety of predeposit blood autodonation in 500 cases of myocardial revascularization

Since 1985 all patients scheduled for coronary artery bypass grafting have been evaluated for admission to a program of predeposited blood autodonation. From a total of 816 consecutive patients, 505 were admitted to the program (group 1). The other 311 (group 2) were excluded on the basis of one or more of the following criteria: 1) emergency surgical indication, 2) hemoglobin less than 12 g/dl, or 3) uncontrolled angina or clinically manifest cardiac failure. Postoperative use of homologous blood products was required by 16% of the group 1 and 44% of the group 2 patients (p less than 0.001). Altogether 597 patients (73%) had no contact with homologous blood products. There was no intergroup difference in the incidence of postoperative complications. Non-A, non-B hepatitis developed in three group 1 and four group 2 patients. Its incidence was 0.9% among all discharged patients and 3.2% of the homologous blood recipients. The findings emphasize the safety and value of the autodonation with predeposit program in significantly reducing the requirement for homologous blood in coronary artery bypass grafting.