lock Open Access lock Peer-Reviewed




Autodonation and autotransfusion of pre-donated blood in cardiac surgery with cardiopulmonary bypass

Mário Gesteira Costa; Frederico Vasconcelos; Roberto Pereira; Carlos Antônio Silveira; Esdras Gaspar; Gilberto Godoy; Milton Garret; Maria de Lourdes Souza; Antônio Carlos Leão

DOI: 10.1590/S0102-76381989000200003


This is a prospective study performed from August 1987 to September 1988, including 80 adult patients who underwent elective cardiac surgery with cardiopulmonary bypass, for the purpose of assessing the efficacy of autodonation (AD) and autotransfusion (AT) in reducing the use of homologous blood and blood products (SDH). The Control Group (GC) did not undergo autodonation (n=38). Pre-operative collection of flood was performed in 42 patients, forming the autodonation Group (GAD), beginning from I to 7 days pre-operatively (GAD I; n=29), and from 8 to 14 days pre-operatively (GAD II; n = 13). Groups GC and GAD had very similiar "pre", "intra" and "post-operative" parameters. The results showed that the use of blood and blood products was similar in the various groups. Nevertheless, the number of patients exposed to SDH (GC 27 (71%) x GAD 10 (23.8%) - p < 0.001), the mean volume of SDH (GC 1241 x GAD 412 ml - p < 0.003) and the mean number of Homologous Units used (GC 6.31 x GAD 1.95 - p < 0.001) demonstrated that AD and AT were efficacious, reducing in 64% the mean volume of SDH, diminishing the exposure to Homologous Units and minimizing the number of patients exposed. The GAD II attained the best indexes, not reaching, however, statistical significance when compared to GAD I, possibility due to the small number of patients. We believe that AT & AD should de encouraged in elective cardiac surgery.


Estudo prospectivo, entre agosto de 1987 e setembro de 1988, em 80 pacientes adultos submetidos a cirurgia cardíaca eletiva com circulação extracorpórea (CEC) aferindo a eficácia da autodoação (AD) e autotransfusão (AT) em reduzir o uso de sangue e hemoderivados homólogos (SDH). O Grupo Controle (GC) não foi submetido a AD (n =38). Coleta pré-operatória de sangue foi realizada em 42 pacientes, constituindo o Grupo Autodoação (GAD), iniciando-se de um a sete dias pré-operatórios (GAD I n=29) e entre oito a 14 dias pré-operatórios (GAD II n = 13). Os Grupos GC e GAD foram bastante semelhantes nos seus parâmetros pré, intra e pós-operatórios. Os resultados demonstraram que a utilização de hemoderivados foi similar, nos diversos grupos. Contudo, o número de pacientes expostos a SDH: GC 27 (71%) x GAS 10 (23,8%), p < (0,001); o volume médio de SHD (GC 1241 ml x GAD 412 ml, p <0,003) e o número médio de unidades homólogas utilizadas (GC 6,31 x GAD 1,95, p < 0,001) demonstraram que AD e AT foram eficazes em reuzir em 64% o volume médio de SDH, diminuindo a exposição a unidades homólogas e minimizando o número de pacientes expostos. O GAD II obteve os melhores índices, mas não atinge significado estatístico quando comparado ao GAD I, talvez devido ao pequeno número de pacientes. Acreditamos que AD e AT devem ser incentivadas em cirurgia cardíaca eletiva.
Full text available only in portuguese PDF format.


1. ALTER, M. J.; GERETY, F. J.: SMALLWOOD, L. A.; SAMPLINER, R. E.; TABOR, E.; DEINHARDT, F.; FORSNER, G.; MATANOSKI, G. M. - Sporadic non-A, non-B hepatitis: frequency, epidemiology in an urban U.S. population. J. infect.Dis., 145: 886-893, 1982. [MedLine]

2. BERMAN, M.; ALTER, H. J.; ISHAK, K. G.; PURCELL, R. H.; JONES, E. A. - The chronic sequelae of non-A, non-B hepatites. Ann. Intern. Med., 91: 1-6, 1979. [MedLine]

3. COSGROVE, D. M.; AMIOT, D. M.; MESERKO, J. J. - An inproved technique for autotransfusion of shed mediastinal blood. Ann. Thorac. Surg., 40: 519-600, 1985.

4. COSGROVE, D. M.; LOOP, F. D.; LYTLE, B. W.; GILL, C. G.; GOLDING, L. R.; TAYLOR, P. C.; FORSYTHE, S. B. - Determinants of blood utilization during myocardial revascularization. Ann. Thorac. Surg., 40: 380-384, 1985. [MedLine]

5. COSGROVE, D. M.; THURER, R. L; LYTLE, B. W.; GILL, C. G.; PETER, M.; LOOP, F. D. - Blood conservation during myocardial revascularization. Ann. Thorac. Surg., 28: 184-189, 1979. [MedLine]

6. COVE, H.; MATLOFF, J.; SACKS, H. J.; SHERBECOE, R.; GOLDFINGER, D. - Autologous blood transfusion in coronary artery bypass surgery. Transfusion, 16: 245-248, 1976. [MedLine]

7. CUELLO, L.; VAZQUEZ, E.; RIOS, R.; RAFUCCI, F. L. - Autologous blood transfusion in thoracic and cardiovascular surgery. Surgery, 62: 814-818, 1967. [MedLine]

8. FINCH, F.; HASKINS, D.; FINCH, C. A. - Iron metabolism. Hematopoiesis following phlebotomy: iron as a limiting factor. J. Clin. Invest., 29: 1078-1085, 1950.

9. GIORDANO, G. F.; GODMAN, D. S.; MAMMANA, R. B.; MARCO, J. D.; NESTOR, J. D.; RACZKOWSKI, A. R.; RIVERS, S. L.; SANDERSON, R. G. STRUG, B. S.; SANDLER, S. G. - Intraoperative autotranfusion in cardaic operations: effect on intraoperative and postoperative transfusion requirements. J. Thorac. Cardiovasc. Surg., 96: 382-386, 1988. [MedLine]

10. GIORDANO, G. F.; RIVERS, S. L.; CHUNG, G K. T.; MAMMANA, R. B.; MARCO, J. D.; RACZKOWSKI, A. R.; SABBAGH, A.; SANDERSON, R. G.; STRUG, B. S. - Autologous platelet-rich plasma in cardiac surgery: effect on intraoperative and postoperative transfusion requirements. Ann. Thorac. Surg., 46: 416-419, 1988. [MedLine]

11. HALLOWELL, P.; BLAND, J. H. L.; BUCKLEY, M. J.; LOWENSTEIN, E. - Transfusion of fresh autologous blood in open-heart surgery: a method for reducing bank blood requirements. J. Thorac. Cardiovasc. Surg., 64: 941-948, 1972. [MedLine]

12. HONIG, C. L. & BOVE, J. R. - Transfusion associated fatalities: Review of Bureau of Biologies Reports 1976-1978. Transfusion, 20: 653-661, 1980. [MedLine]

13. JOHNSON, R. G.; ROSENKRANTZ, K. R.; PRESTON, R. A.; HOPKINS, C.; DAGGENT, W. M. - The efficacy of postoperative autotransfusion in patients undergoing cardiac operations. Ann. Thorac. Surg., 36: 173-179, 1983. [MedLine]

14. LINKER, C. & WALLERSTEIN, R. O. - Blood transfusion. In: SCHOROEDER, S. A.; KRUPP, M. A.; THERNEY Jr., E. M. - Current medical diagnosis and treatment. 27. ed. Connecticut, Appleton & Lange, 1988. p. 338-341.

15. LOOP, F. D.; WILCOX, B. R.; CUNNINGHAM Jr., J. M.; FOSBURG, R. G.; GEHA, A. S.; LAKS, H.; MARK, J. B. D.; BADHWAR, K. - Thoracic surgery manpower: the fourth manpower study of thoracic surgery: 1985. Report of the Ad Hoc Committee on Manpower of the American Association for Thoracic Surgry and the Society of Thoracic Surgeons. Ann. Thorac. Surg., 44: 450-461, 1987. [MedLine]

16. LOVE, T. R.; HENDREN, W. G.; O'KEEFE, D. D.; DAGGETT, W. M. - Transfusion of predonated autologous blood in elective cardiac surgery. Ann. Thorac. Surg., 43: 508-512, 1987. [MedLine]

17. LUBIN, J.; GREENBERG, J. J.; YAHR, W. Z.; HAYNES, J. I.; PAUL, E. - The use of autologous blood in open-heart surgery. Transfusion, 14: 602-607, 1974. [MedLine]

18. MANN, M.; SACKS, H. J.; GOLDFINGER, D. - Safery of autologous blood donation prior to elective surgery for a variety of potentially "high-risk" patients. Transfusion, 23: 229-232, 1983. [MedLine]

19. MORAN, J. M.; BABKA, R.; SILBERMAN, S.; RICE, P. L.; PIFARRÉ, R.; SULLIVAN, H. J.; MONTOYA, A. - Immediate centrifugation of oxygenator contents after cardiopulmonary bypass: role in maximum blood conservation. J. Thorac. Cardiovasc Surg., 76: 510-517, 1978. [MedLine]

20. NEWMANN, M. M.; HAMSTRA, R.; BLOCK, M. - Use of banked autologous blood in elective surgery. JAMA 218: 861-863, 1971. [MedLine]

21. ROCHE, J. K. & STENGLE, J. M. - Open-heart surgery and the demand for blood. JAMA, 225: 1516-1521, 1973. [MedLine]

22. SCHWARTZ, S. I. - Hemostasis, surgical bleeding and transfusion. In: SCHWARTZ, S. I.; SIRES, G. T.; SPENCER, F. C.; STORER, E. H. Principles of surgery. 3. ed. New York, McGraw Hill Inc., 1979. p. 129-130.

23. TECTOR, A. J.; GABRIEL, R. P.; MATEICKA, W. E.; OPARAH, S. S.; FLEMMA, R. J.; LEPLEY Jr., D. - Reduction of blood usage in open heart surgery. Chest, 70: 454-457, 1976. [MedLine]

24. WILSON, J. D. & TASWELL, H. F. - Autotransfusion: historical review and preliminary report on a new method. Mayo Clin. Proc., 43: 26-35, 1968. [MedLine]

25. YEH Jr., T.; SHELTON, L.; YEH, T. J. - Blood loss and bank blood requirement in coronary bypass surgery. Ann. Thorac. Surg., 26: 11-16, 1978. [MedLine]

26. AUHDI, N.; Mc COLLOUGH, B.; CAREY, J.; GREER, A. - Double-helical reservoir heart-lung machine designed for hypothermic perfusion primed with 5% glucose in water inducing hemodilution. Arch. Surg., 82: 320-325, 1961. [MedLine]

CCBY All scientific articles published at are licensed under a Creative Commons license


All rights reserved 2017 / © 2019 Brazilian Society of Cardiovascular Surgery DEVELOPMENT BY