Predeposit Autologous Blood Transfusions in Patients Undergoing Irradiation and Radical Cystectomy

Swanson, David A.; Lo, Richard K.; Lichtiger, Benjamin

doi:10.1016/s0022-5347(17)51555-4

Cited by 28 publications

(8 citation statements)

References 6 publications

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“…There is considerable variation in blood use for radical prostatectomy from one study to another (see Table 3); from 0.59 units per case (Yamada et al, 1993) to 4.47 units per patient for the first cohort of p.atients in this study. Use in the second cohort (2.54 units/patient) is similar to that seen in other studies (Friedman et al, 1979;Peters & Walsh, 1985;Toy et al, 1993). The reasons for the variation between studies may include differences in case selection and The availability of autologous blood has previously been seen to influence transfusion practice, in that patients without autologous blood available received less transfusion than those who had predeposited autologous blood (Yamada er al., 1993).…”

Section: Discussionsupporting

confidence: 66%

Transfusion practice in urological surgery: modifications in association with the introduction of an autologous blood donor programme

Pinkerton

Klotz

1995

Transfusion Medicine

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The transfusion records of 122 urological patients who had deposited one or more units of autologous blood were analysed. The 95 patients undergoing radical prostatectomy were arbitrarily divided into two cohorts (the first 47 patients enrolled, and the last 48 enrolled) to assess changes in use of blood. The avoidance of allogeneic transfusion in radical prostatectomy was 64% in the first cohort studied, and increased to 81% in the second. There was a significant decline in the mean absolute amounts of blood used from 4.47 to 2.54 units per patient from the first to second cohorts. Introduction of an autologous blood donor programme has been associated with a reduction in total blood use for radical prostatectomy, and a decrease in the number of patients exposed to allogeneic blood. The validity of an autologous blood-order schedule of 3 units for radical prostatectomy is supported.

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Section: Discussionsupporting

confidence: 66%

Transfusion practice in urological surgery: modifications in association with the introduction of an autologous blood donor programme

Pinkerton

Klotz

1995

Transfusion Medicine

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“…6,42 The drop in serum iron and serum ferritin concentrations shows that iron absorption cannot cope with increased demand. The serum ferritin concentrations measured, however, are usually not associated with depleted iron stores.…”

Section: Discussionmentioning

confidence: 99%

Serial immunoreactive erythropoietin levels in autologous blood donors

Lorentz¹,

Jendrissek²,

Eckardt

et al. 1991

Transfusion

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The variations in plasma erythropoietin (EPO) concentration during preoperative deposit of autologous blood were studied in 12 patients (8 men, 4 women). Four donations were scheduled at weekly intervals. A predonation hemoglobin concentration of 11 g per dL (110 g/L) was required. Hemoglobin concentration decreased from 14.3 ± 1.1 g per dL (143 ± 11 g/L) (mean ± SD) before the first donation to 11.7 ± 0.7 g per dL (117 ± 7 g/L) on Day 22 (p<0.0001). Reticulocyte counts increased from a median of 31,800 (range, 4900-95,000) per \xL (median, 32 x 10 9 /L [range, 5-95 x 10 9 /L]) to 93,800 (16,800-194,900) per \iL (median, 94 x 10 9 /L [range, 17-195 x 10 9 /L]) on Day 28 (p<0.01). Plasma EPO concentration was 17.8 ± 5.1 mU per mL prior to the first donation and displayed a small and transient peak after each donation. A sustained elevation followed each peak. Although plasma EPO concentration differed significantly from the baseline value after the first donation, only the peak concentrations after the second (35.5 ± 15.5 mU/mL), third (38.0 ± 14.5 mU/ mL), and fourth (36.1 ±11.0 mU/mL) donations exceeded the normal range. The moderate, biphasic increase in plasma EPO concentration and the moderate increase in erythropoiesis suggest two strategies in autologous blood donation that should be investigated with respect to efficiency and safety: 1) more aggressive donation schemes, which reduce donation intervals and/or the minimum hemoglobin concentration and 2) the administration of recombinant human EPO. TRANSFUSION 1991;31:650-654. Abbreviations: EPO = erythropoietin.THE IMMUNOLOGIC AND INFECTIOUS risks of transfusion 1,2 can be minimized by the use of autologous blood. Preoperative autologous blood donation considerably reduces homologous transfusion requirements in surgery. 3 " 8 Frozen storage of red cells allows the preoperative deposit of a large number of blood units, but it is costly and time-consuming. On the other hand, liquid storage is limited to 5 weeks for whole blood and 7 weeks for packed red cells. 9,10 The efficiency of preoperative deposit in the liquid state thus depends on the rate of recovery from blood loss, that is, on the degree of stimulation of erythropoiesis.Erythropoietin (EPO) is the primary humoral regulator of erythropoiesis. 11 Increasing the availability of EPO may therefore enhance the efficiency of preoperative donation programs. This increased availability of EPO may be achieved by allowing the modulation of donation schemes (shorter donation intervals, lower minimum

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“…Nationally, single-unit transfusions ac¬ count for 20% of transfused patients. In addition, 17 It appears that autotransfusion can be safely used in surgery for patients with malignant tumors of the geni¬ tourinary tract. In such an elective type of surgery, utilizing predeposited blood and autotransfusion, the need for ho¬ mologous blood transfusion may be omitted or at least reduced to a minimum.…”

Section: Resultsmentioning

confidence: 99%

Intraoperative Autotransfusion in Urologic Oncology

Klimberg¹

1986

Arch Surg

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Predeposit Autologous Blood Transfusions in Patients Undergoing Irradiation and Radical Cystectomy

Cited by 28 publications

References 6 publications

Transfusion practice in urological surgery: modifications in association with the introduction of an autologous blood donor programme

Transfusion practice in urological surgery: modifications in association with the introduction of an autologous blood donor programme

Serial immunoreactive erythropoietin levels in autologous blood donors

Intraoperative Autotransfusion in Urologic Oncology

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