by Skarnulis L

Do You Need Blood? You May Be Your Own Best Donor!

IMAGE If you needed a blood transfusion, who would be the ideal blood donor? The answer might be you.
Did you know that for several weeks before elective surgery, you can donate your own blood? This practice is called preoperative autologous donation (PAD), and it is an alternative to transfusing blood from the community blood supply (called allogeneic transfusion).
PAD is often used for people undergoing elective surgeries that can cause enough blood loss to require transfusions, such as hip or knee replacement or vascular or cardiac surgery.

Who Can Do It?

If you are healthy enough to undergo elective surgery, PAD is probably safe. Age will not rule you out, but an infection or low hemoglobin count will. Your doctor may recommend PAD if there is an especially high possibility of an incompatibility reaction to allogeneic blood, which can happen if your blood carries antibodies that will attack the donated blood cells.

Why Use PAD?

The body may have an immune reaction to donated blood. Such transfusion reactions are usually mild and might include chills, fever, backache and hives; but more serious complications can also occur. Fortunately, the careful matching of blood that occurs before elective surgery makes these reactions rare, so if you cannot give your own blood, do not worry.

How Is It Done?

You may donate 1 unit per week but no more than 1 unit every 3 days. If you need 4 units or less, donation should start 3 to 4 weeks before surgery. If you need more units, donation should occur several months before. A donation center may need to be contacted regarding freezing red blood cells.
Because you are giving blood to yourself, you do not have to pass the strict screening required of volunteers. You will need a doctor's prescription, which you will take to the blood center.
Here is what you can expect:
  • You will be asked to sit. An area inside your elbow will be cleaned with an antiseptic wipe. A large band will be tied around your arm. The needle will then be inserted into a vein and the band removed. Tubing and a collection bag will collect the blood from the needle.
  • It takes about 10 minutes to collect one pint of blood.
  • You will remain briefly in an observation area where you can rest and eat a light snack.
  • Your body will replace the fluid lost in about 24 hours.
  • Red blood cells take longer to recover, so your doctor may give you iron pills so your body can use the iron to make more blood.

What If You Cannot Use PAD?

Allogeneic blood transfusion is safe. There are rigorous tests and multiple safeguards to make blood safe for transfusion from donor to recipient.
There is testing called nucleic acid amplification testing or NAT. Unlike blood tests that detect infections like HIV or hepatitis C only after someone develops antibodies, NAT detects genetic materials of the viruses themselves. This increases the likelihood of detecting tainted blood from a donor who is newly infected.
A number of other safeguards are in place:
  • Red blood cells always come from volunteer, not paid donors.
  • Only healthy donors are accepted. Donor screening includes questions that try to reveal behaviors that may increase the risk of infection with transmittable diseases.
  • Donors are informed about conditions that would render their blood unsafe and are given an opportunity to confidentially indicate that their blood should be discarded.
  • Multiple screening tests are run on blood to identify diseases that can be transmitted by transfusion.
Before a transfusion, samples of the recipient's blood and donated blood are combined to test for negative reactions, a procedure called crossmatching.

What Are the Other Options?

There are two transfusion options that make use of your own blood that involve procedures done right in the operating room. One is called intraoperative blood salvage, a practice usually seen in vascular and cardiac surgery. During this procedure, the blood lost during surgery is washed and reinfused.
Hemodilution is another option. Several units of blood are removed and replaced with a protein or sugar solution. At the end of the surgery, your own blood is reinfused.
Directed donations from friends or family can be an option, but you should avoid choosing people who are not regular blood donors. Otherwise, you are probably better off using allogeneic blood whose donors have undergone testing many times.

What Is the Cost?

Contact your hospital's blood donation center for specific information. Also check with your health insurance to find out if blood donation is covered in your policy.

RESOURCES

American Association of Blood Banks http://www.aabb.org

American Red Cross http://www.redcross.org

CANADIAN RESOURCES

Canadian Blood Services http://www.bloodservices.ca

Canadian Red Cross http://www.redcross.ca

References

Acute normovolemic hemodilution (ANH). Society for the Advancement of Blood Management website. Available at: http://www.sabm.org/glossary/acute-normovolemic-hemodilution-anh. Accessed October 15, 2014.

Blood testing. American Red Cross website. Available at: http://www.redcrossblood.org/learn-about-blood/what-happens-donated-blood/blood-testing. Accessed October 14, 2014.

Blood types. American Red Cross website. Available at: http://www.redcrossblood.org/learn-about-blood/blood-types. Accessed October 14, 2014.

Eligibility requirements. American Red Cross website. Available at: http://www.redcrossblood.org/donating-blood/eligibility-requirements. Accessed October 14, 2014.

Donation FAQs. American Red Cross website. Available at: http://www.redcrossblood.org/donating-blood/donation-faqs. Accessed October 14, 2014.

Goodnough LT, Shander A. Blood management [review]. Arch Pathol Lab Med. 2007;131:695-701.

Intraoperative blood salvage. NoBlood.org website. Available at: http://www.noblood.org/content/intraoperative%5Fblood%5Fsalvage-209. Accessed October 14, 2014.

Iron info for frequent donors. American Red Cross website. Available at: http://www.redcrossblood.org/iron/frequent-donors. Accessed October 14, 2014.

Lee GC, Cushner FD. The effects of preoperative autologous donations on perioperative blood levels. J Knee Surg. 2007;20:205-209.

Pre-operative autologous donation (PAD). United Blood Services for Hospitals & Physicians website. Available at: http://hospitals.unitedbloodservices.org/preoperative-autologous-donation.html. Accessed October 14, 2014.

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