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The current role of preoperative and intraoperative autologous blood donation in pediatric open-heart surgery

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Abstract

Objective: We assessed the current role of preoperative and intraoperative autologous blood donation in pediatric open-heart surgery. Methods: Group 1 consisted of 51 patients between 5 and 10 years old who underwent preoperative autologous blood donation. Group 2 consisted of 50 age-matched patients without preoperative donation as controls. Intraoperative donation was conducted in both groups prior to cardiopulmonary bypass. We evaluated perioperative blood cell count, blood loss, and the need for homologous blood products. Results: No serious complications occurred in preoperative or intraoperative donation. Total preoperative donation storage was 17.5±3.4 mL/kg. Intraoperative donation was 21.7 ±6.1 mL/kg in Group 1 and 12.8±4.0 mL/kg in Group 2 (p<0.001). On admission, serum hemoglobin was lower in Group 1 (12.2±1.0 g/dL versus 13.6±1.6 g/dL, p<0.001) but returned postoperatively to the preoperative value. It hovered at a depressed level in Group 2 (12.2±1.4 versus 10.2±1.1 g/dL, p<0.001). The homologous blood requirement was significantly less in Group 1 than in Group 2 (0% versus 10%, p<0.05). Postoperative platelet counts showed similar curves, and blood loss was not statistically significantly different between groups. Conclusion: Preoperative and intraoperative donations are safe and continue to contribute uniquely to blood conservation, providing important options in comprehensive blood conservation programs in current pediatric open-heart surgery.

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References

  1. Maeda M, Koyama T, Murase M, Teranishi K, Sakurai H, Nishizawa T. The indications and limitations of open heart surgery without homologous blood transfusion in children and infants (Eng abstr). J Jpn Assn Thorac Surg 1994; 42: 1–7.

    CAS  Google Scholar 

  2. Sakamoto T, Nagase Y, Watanabe H, Shibairi M, Utsumi K, Nakano H, et al. Open heart surgery without blood transfusion for cyanotic congenital cardiac defects (Eng abstr). Jpn J Thorac Cardiovasc Surg 1998; 46: 138–44.

    PubMed  CAS  Google Scholar 

  3. Honek T, Horvath P, Kucera V, Kostelka M, Hucin B, Stark J, Minimisation of priming volume and blood saving in paediatric cardiac surgery. Eur J Cardiothorac Surg 1992; 6: 308–10.

    Article  PubMed  CAS  Google Scholar 

  4. Koyama T, Murase M, Maeda M, Yamada T, Kurita K, Hara S, et al. Usefulness of “low-vacuum suction method” for cardiopulmonary bypass. Jpn J Artif Organs 1995; 24: 595–9.

    Google Scholar 

  5. Casati V, Guzzon D, Oppizzi M, Bellotti F, Franco A, Gerli C, et al. Tranexamic acid compared with high-dose aprotinin in primary elective heart operations: effects on perioperative bleeding and allogeneic transfusions. J Thorac Cardiovasc Surg 2000; 120: 520–7.

    Article  PubMed  CAS  Google Scholar 

  6. Levy JH. Pharmacologic preservation of the hemostatic system during cardiac surgery. Ann Thorac Surg 2001; 72: S1814–20.

    Article  Google Scholar 

  7. Sonzogni V, Crupi G, Poma R, Annechino F, Ferri F, Filisetti P, et al. Erythropoietin therapy and preoperative autologous blood donation in children undergoing open heart surgery. Br J Anaesth 2001; 87: 429–34.

    Article  PubMed  CAS  Google Scholar 

  8. Sandrelli L, Pardini A, Lorusso R, Sala ML, Licenziati M, Alfieri O. Impact of autologous blood predonation on a comprehensive blood conservation program. Ann Thorac Surg 1995; 59: 730–5.

    Article  PubMed  CAS  Google Scholar 

  9. Forgie MA, Wells PS, Laupacis A, Fergusson D. Preoperative autologous donation decreases allogenic transfusion but increases exposure to all red blood cell transfusion: results of a meta-analysis: international study of perioperative transfusion (ISPOT) investigators. Arch Intern Med 1998; 158: 610–6.

    Article  PubMed  CAS  Google Scholar 

  10. Masuda M, Kawachi Y, Inaba S, Matsuzaki K, Fukumura F, Morita S, et al. Preoperative autologous blood donations in pediatric cardiac surgery. Ann Thorac Surg 1995; 60: 1694–7.

    Article  PubMed  CAS  Google Scholar 

  11. Fukahara K, Murakami A, Ueda T, Doki Y, Tsubata S, Ichida F, et al. Scheduled autologous blood donation at the time of cardiac catheterization in infants and children. J Thorac Cardiovasc Surg 1997; 114: 504–5.

    Article  PubMed  CAS  Google Scholar 

  12. Masuda H, Moriyama Y, Hisatomi K, Toda R, Shimokawa S, Iguro Y, et al. Preoperative autologous donation of blood for a simple cardiac anomaly: analysis of children weighing under twenty kilograms. J Thorac Cardiovasc Surg 2000; 120: 783–9.

    Article  PubMed  CAS  Google Scholar 

  13. Schönberger JPAM, Bredée JJ, Tjian D, Everts PAM, Wildevuur CRH. Intraoperative predonation contributes to blood saving. Ann Thorac Surg 1993; 56: 893–8.

    Article  PubMed  Google Scholar 

  14. Laub GW, Dharan M, Riebman JB, Chen C, Moore R, Bailey BM, et al. The impact of intraoperative autotransfusion on cardiac surgery: a prospective randomized double-blind study. Chest 1993; 104: 686–9.

    PubMed  CAS  Google Scholar 

  15. Kochamba GS, Pfeffer TA, Sintek CF, Khonsari S. Intraoperative autotransfusion reduces blood loss after cardiopulmonary bypass. Ann Thorac Surg 1996; 61: 900–3.

    Article  PubMed  CAS  Google Scholar 

  16. Aach RD, Kahn RA. Post-transfusion hepatitis: current perspectives. Ann Intern Med 1980; 92: 539–46.

    PubMed  CAS  Google Scholar 

  17. Carson JL, Russell LB, Taragin MI, Sonnenberg FA, Duff AE, Bauer S. The risks of blood transfusion: the relative influence of acquired immunodeficiency syndrome and non-A, non-B hepatitis. Am J Med 1992; 92: 45–52.

    Article  PubMed  CAS  Google Scholar 

  18. Dodd RY. The risk of transfusion-transmitted infection. N Engl J Med 1992; 327: 419–21.

    Article  PubMed  CAS  Google Scholar 

  19. DeCampli WM. Commentary on a paper by Masuda H et al. J Thorac Cardiovasc Surg 2000; 120: 788–9.

    Article  Google Scholar 

  20. Koyama T, Yamada T, Katayama K, Takagi M, Tamaki S, Murayama H, et al. The vacuum control system for cardiopulmonary bypass. Jpn J Artif Organs 1999; 28: 517–22.

    Google Scholar 

  21. Helm RE, Klemperer JD, Rosengart TK, Gold JP, Peterson P, DeBois W, et al. Intraoperative autologous blood donation preserves red cell mass but dose not decrease postoperative bleeding. Ann Thorac Surg 1996; 62: 1431–41.

    Article  PubMed  CAS  Google Scholar 

  22. Buchmiller-Crair TL, Kim CS, Won NH, Chopourian HL, Shaw KS, Fonkalsrud EW. Effect of acute anemia on the healing of intestinal anastomoses in the rabbit. J Trauma 2001; 51: 363–8.

    Article  PubMed  CAS  Google Scholar 

  23. Ferraris VA, Ferraris SP. Risk factors for postoperative morbidity. J Thorac Cardiovasc Surg 1996; 111: 731–41.

    Article  PubMed  CAS  Google Scholar 

  24. Nelson AH, Fleisher LA, Rosenbaum SH. Relationship between postoperative anemia and cardiac morbidity in high-risk vascular patients in the intensive care unit. Crit Care Med 1993; 21: 860–6.

    Article  PubMed  CAS  Google Scholar 

  25. Murao S, Fujieda H, Sakamoto T, Sato T, Sato H. Regional left ventricular dysfunction in a patient with severe prolonged anemia. Jpn Circ J 1999; 63: 61–3.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Social Insurance Chukyo Hospital, 1-1-10 Sanjo, Minami-ku, 457-8510, Nagoya, Japan

    Hiroomi Murayama MD, Masanobu Meda MD, Ken Miyahara MD, Yoshimasa Sakai MD, Hajime Sakurai MD, Hiroki Hasegawa MD & Akemi Kawamura MD

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  1. Hiroomi Murayama MD
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  2. Masanobu Meda MD
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  3. Ken Miyahara MD
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  4. Yoshimasa Sakai MD
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  5. Hajime Sakurai MD
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  6. Hiroki Hasegawa MD
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  7. Akemi Kawamura MD
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Murayama, H., Meda, M., Miyahara, K. et al. The current role of preoperative and intraoperative autologous blood donation in pediatric open-heart surgery. Jpn J Thorac Caridovasc Surg 51, 91–97 (2003). https://doi.org/10.1007/s11748-003-0079-3

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  • DOI: https://doi.org/10.1007/s11748-003-0079-3

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