Effects of Preoperative Autologous Blood Donation in Patients Undergoing Open Heart Surgery.

Mihee Lim, Hyunggon Je, Sang-Kwon Lee, Ji Hye Lee

Department of Cardiovascular and Thoracic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Yang san, Korea (South)

Date, time and location: 2018.05.26 17:00, Exhibition area, 1st Floor. Zone – C

Abstract

Objective

Generally, cardiac surgery requires the allogeneic blood transfusion, which can lead to a variety of complications. Preoperative autologous blood donation(PABD) is considered to be an effective solution reducing the transfusion. The aim of this study was to evaluate the effect of additional PABD over comprehensive blood conservation strategies on the rate of allogeneic transfusion and the postoperative progress.

Methods

Because we started a PABD program since January 2016, we conduct this retrospective analysis between January 2015 and June 2017 using the prospectively collected database. Among 350 consecutive patients who underwent cardiac surgery by a single surgeon, we compared the patients with PABD program (group I,n=45), if such existed, from January to December 2015, and the patients with PADB program between January 2016 and June 2017 (groupⅡ,n=75) after considering the exclusion criteria. The primary outcomes were the rate of allogeneic transfusion and the postoperative results.

Results

Groups I and II were similar in terms of age, EuroSCORE II and left ventricular ejection fraction.Most of the patients who were eligible for PABD were younger, stronger and had a fewer accompanying disease.However, the hemoglobin before surgery was significantly lower in groupⅡ. Most of the surgery was performed with MICS approach in both groups(92%). The in-hospital mortality rate was 0%. No significant difference was observed in terms of hospital stay, major postoperative complications.However, unexpectedly, chest tube drain and rate of allogenic blood transfusion incidence were numerically higher in the groupⅡ without statistical difference.

Conclusions

Because of incomplete recovery of hemoglobin levels after PABD and the high proportion of MICS approach, the additional PABD did not reduce the incidence of allogeneic transfusion. Despite much efforts and costs, it cannot improve the postoperative course. The additional PABD may not have any benefit for low risk, elective, MICS population.