This is most commonly utilized for the orthopedic and urological services. Autologous units are left as whole blood only at the request of the clinician. They are otherwise made into packed red blood cells. Autologous plasma or cryo is not available from these units unless prior arrangements were made. Autologous units are kept until expiration and will not be used for other patients.
Freezing of autologous units. Autologous blood is not routinely frozen. You may authorize the freezing of autologous units for the following indications:
Positive infectious disease markers. Autologous units testing positive for HBsAg, anti-HCV, anti-HIV (confirmed), or anti-HTLV (confirmed) will be discarded and the donor asked not to donate further units. These units are infectious and pose a risk to health care workers handling them. Further, they pose a risk to other patients by virtue of the fact that they are sitting in the inventory and might mistakenly be transfused to the wrong patient. The physician should be notified if the blood cannot be kept. These units will not be frozen. Units testing positive for ALT, anti-HBcore and RPR may be used but must be issued bearing a biohazard sticker on the blood bag.
Donation. Autologous units must be donated during regular weekday hours by appointment at BloodCare or a satellite site (see appendix 11 in paper call maual supplement). Pediatric patients of all ages are eligible to donate autologous units with their parents' permission. The lower limit of eligibility is determined only by their ability to sit still and tolerate the insertion of a 16 gauge needle.
Fee. Autologous blood components cost the patient approximately $100 more than does banked blood. The patient is charged even if the blood is not used (since it can't be "crossed over" for general use).
Shipping of units to and from other blood centers. We can accept autologous units drawn elsewhere. Have a supervisor work out the details of transportation and payment. If the unit is untested for infectious disease markers or is known to be positive for an infectious disease marker, transportation may be forbidden by law.
Timing of donations. All autologous donations should be completed 72 hours prior to surgery. Most donor/patients give one unit per week, but many could tolerte donating twice in one week.
Transfusion reactions. Adverse effects can occur even with the use of autologous blood. Consider the following: volume overload, bacterial contamination, allergy to anticoagulant or preservative or plasticizer, inadequate deglycerolization (if frozen) with hemolysis, mechanical hemolysis.
You should not have to be involved in this procedure. The operating room staff take care of this. If asked, salvage blood should be reinfused within 6 hours. It can be stored unrefrigerated in the O.R. during the surgery.
Drainage blood from hip, knee, or mediastinum can be collected in special containers and reinfused. This blood is generally not handled by the blood bank. Filtration with microaggregate filters is recommended.
This procedure is performed by the anesthesiology service. Units
of whole blood are removed from a patient immediately prior to
surgery. Volume is replaced with crystalloids. The units are
reinfused at the end of the surgical procedure. The anesthesiology
service should have their own supply of collection bags for this
purpose.
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