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MEDICAL PROCEDURES

• Introduction
• Autologous Blood
• Donor Blood
• Blood Transfusion At A Glance

Introduction

A blood transfusion is the transfer of blood or blood products from one person (donor) into another person's bloodstream (recipient). In most situations this is done as a life saving maneuver to replace blood cells or blood products lost through severe bleeding. The following material is provided to all patients and/or their family members regarding blood transfusions and the use of blood products. Although in most situations the likelihood of a blood transfusion associated with surgery is uncommon, at times patients may require blood products. You are encouraged to discuss your particular risk of transfusion with your doctor. Your options may be limited by time and health factors, so it is important to begin carrying out your decision as soon as possible. For example, if friends or family members are donating blood for a patient (directed donors), their blood should be drawn at least two working days prior to the anticipated need to allow adequate time for testing and labeling. You are also encouraged to check with your insurance company for their reimbursement policy.

The safest blood product is your own, so if a transfusion is likely, this is your lowest risk choice. Although you have the right to refuse a blood transfusion, this decision may hold life-threatening consequences. If you are a parent deciding for your child, you as the parent or guardian must understand that in a life-threatening situation your doctors will act in your child's best interest to insure your child's health and well being in accordance with standards of medical care regardless of religious beliefs. Please carefully review this material and decide with your doctor which option(s) you prefer.

The following information was developed by the California Department of Health Services, 714/744 P Street, Sacramento, California 95814. Additional information, can also be obtained through the Blood Donor Services at your local hospital or Red Cross.

Blood can be provided from two sources: Autologous blood (using your own blood) or donor blood (using someone else's blood).

Autologous Blood (using your own blood):

Pre-operative donation - donating your own blood before surgery. The blood bank draws your blood and stores it until you need it during or after surgery. This option is only for non-emergency (elective) surgery. It has the advantage of eliminating or minimizing the need for someone else's blood during and after surgery. The disadvantage is that it requires advanced planning which may delay surgery. Some medical conditions may prevent the pre-operative donation of blood products.

Intra-Operative Autologous Transfusion - recycling your blood during surgery. Blood lost during surgery is filtered, and put back into your body during surgery. This can be done in emergency and elective surgeries. It has the advantage of eliminating or minimizing the need for someone else's blood during surgery. Large amounts of blood can be recycled. This process cannot be used if cancer or infection is present.

Post-Operative Autologous Transfusion - recycling your blood after surgery. Blood lost after surgery is collected, filtered and returned to your body. This can be done in emergency and elective surgeries. It has the advantage of eliminating or minimizing the need for someone else's blood during surgery. This process can't be used in patients where cancer or infection is present.

Hemodilution - donating your own blood during surgery. Immediately before surgery, some of your blood is taken and replaced with IV fluids. After surgery, your blood is filtered and returned to you. This is done only for elective surgeries. This process dilutes your own blood so you lose less concentrated blood during surgery. It has the advantage of eliminating or minimizing the need for someone else's blood during surgery. The disadvantage of this process is that only a limited amount of blood can be removed, and certain medical conditions may prevent hemodilution.

Apheresis - donating you own platelets and plasma. Before surgery, your platelets and plasma, which help stop bleeding, are withdrawn, filtered and returned to you when you need it later. This can be done only for elective surgeries. This process may eliminate the need for donor platelets and plasma, especially in high blood-loss procedures. The disadvantage of this process is that some medical conditions may prevent apheresis, and in actual practice it has limited applications.

Donor Blood (Using someone else's blood):

All donor blood is tested for safety making its risks very small, but no screening program is perfect and risks, such as contraction of the hepatitis virus, still exist.

Volunteer blood - blood collected from the community blood supply (blood banks). This has the advantage of being readily available, and can be life-saving when your own blood is not available. The disadvantage is that there is a risk of disease transmission, such as hepatitis or AIDS, and allergic reactions.

Designated donor blood - blood is collected from the donors you select. You can select people with your own blood type who you feel are safe donors. Like volunteer blood, there is still a risk of disease transmission, such as hepatitis and AIDS, and allergic reactions. This process usually requires several days for advanced donation. It may not necessarily be safer than volunteer donor blood.

Blood Transfusion At A Glance

• Transfusion of your own blood (autologous) is the safest method but requires planning ahead and not all patients are eligible.
• Directed donor blood allows the patient to receive blood from known donors.
• Volunteer donor blood is usually readily available and when properly tested has a low incidence of adverse events.
• Blood conserving techniques are an important aspect of limiting transfusion requirements.

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