Autologous blood

The Institute of Anaesthesiology of the German Heart Centre Munich has been organising preoperative autologous donation for the past 15 years. Experience has shown this to be a very safe way of reducing the use of homologous blood. The guidelines of the National Medical Council (Bundesärztekammer) governing the obtainment of blood and blood components as well as the use of blood products (haemotherapy) specify that autologous blood donations should be undertaken for all elective surgical procedures with an anticipated homologous blood transfusion rate of over 10 %. Experience has shown this to be possible for nearly all cardiac surgical patients.

Autologous blood donation is contraindicated in the following cases:

• severe aortic stenosis associated with coronary heart disease
• aortic stenosis combined with a medical history of multiple syncopes
• acute infections
• tooth extraction within the last three days prior to the scheduled blood donation
• mean corpuscular haemoglobulin < 110g/L. However, as this value is dependent upon the type of surgery and the age and gender of patient, a definite limit cannot be given.

The anaesthetist responsible for autologous blood donation at our centre will decide whether or not autologous blood donation is indicated after reviewing the patient's medical records. The blood products are processed and stored in the Department of Autologous Blood Donation and in the blood bank of the German Heart Centre Munich. A preoperative plasmapheresis may also be performed, if indicated.

While donating blood, the patient has the opportunity to learn about the upcoming operation. At the same time we acquire information on the patient's medical history prior to admission. The autologous blood donation is thus like an anaesthetist's visit prior to admission of the patient to hospital for surgery.

Procedure

To register, please phone Mrs. Mayer on: +49 (0) 89 1218-4611 or -4614 at the Institute of Anaesthesiology. Each patient registering for autologous blood donation should already have a definite date for surgery.

The physician taking blood will decide whether or not the patient is suited to donating his own blood. Prior to every autologous blood donation, anaemia is ruled out by determining the mean corpuscular haemoglobin concentration.

As a rule, two autologous blood donations are sufficient to avoid a homologous blood transfusion during most operations in 90-95 % of cases. However, experience has shown that even one autologous blood donation conducted one week before admission can lead to a significant reduction in the amount of homologous blood transfusions required. There should be an interval of seven to ten days between donations to allow for regeneration of blood cells. The blood products are manufactured and stored according to the specified guidelines. Autologous blood donations that have not been used must be destroyed for safety reasons.

Donors not living in the Munich area may be able to donate blood at blood donation centres located in their vicinity. However, the arrangements should be discussed with the Institute of Anaesthesiology prior to donation (Phone: +49 (0) 89 1218-4611 or -4614).