Donating autologous blood

The RKU generally applies measures to exclude the necessity of foreign blood usage for all larger operations with a predictable high blood loss. Thus, these patients planned for such a surgery go to donate their own blood approximately 4 weeks prior to surgical treatment, there being withdrawn either blood plasma or red blood cell concentrate or both blood components altogether.

As with a normal blood donation, autohaemotransfusion is effected by withdrawing blood from a vein. Then the plasma is separated from the red blood cells by centrifugal treatment. The blood plasma, comprising different proteins and coagulation factors, is then collected in special transfusion bags and frozen. The red blood cells are generally returned to the original donator (e.g. in case of hip arthoplasties or joint prosthesis surgeries). If the surgery is assumed to be accompanied with a severe loss of blood, also the red blood cells will be collected in transfusion bags and stored in special refrigerators until the point of operation.

Depending on the type of surgery, the patients do one to three own blood donation terms, each taking approximately 1.5 hours and resulting in a blood gain of up to 1200ml of blood plasma. Simultaneously, a vein of the opposite arm is equipped with an infusion to make up for the fluid loss. In case red blood cells are donated as well (amounting to 250ml to 500ml) donation will take about half an hour longer. As to be able to permanently check pulse and blood pressure, the patient is connected to a supervising monitor during the entire autohaemotransfusion process.

The patient must not be without breakfast or lunch when undergoing autotransfusion. Also medicines should be taken as always, with the exception of the haemodelution drug Marcumar, which is to be discontinued as agreed with the family physician approx. 7 to 10 days before an intended own blood donation.

Also the blood the patient looses in the course of the surgery is collected in special containers for later on-demand mechanical processing in the so called cellsaver. Following a "washing" procedure, the erythrocytes can then be returned to the patient. The same method of recycling is applied for retaining the red blood cells from the wound drainages right after the surgery. Following bleeding arrest at surgery completion, the blood plasma as well as the red blood cell concentrate is principally returned to the patient later at the anaesthetic recovery room or the intensive care unit, if circumstances so require.