Gauchers News Contents
Donating your own blood prior to planned surgery has become a common procedure in the USA and is a subject that a number of patients with Gauchers disease have investigated. This is a summary of the advantages and risks. The Gauchers Association would like to thank the doctors listed at the bottom of the page for contributing to this article.
Autologous Blood Transfusion means donating a number of units of your blood for your own use up to five weeks before planned surgery.
Depending on how much blood you may need and the condition of your blood, a unit of blood can be collected once every week. The last donation should be taken no less than one week before surgery.
This procedure has been in common use for several years, especially in the USA. It means that the blood you receive during an operation will match yours and therefore reduces the slight risk of getting an allergic reaction or receiving contaminated blood. (UK blood donors are carefully screened before their blood is used for transfusion into patients so the risk is very small).
The procedure may be worth considering for adults with Gauchers disease facing surgery, eg orthopaedic surgery, especially if they have a rare blood type or have already had a previous transfusion of donor blood. Some people may not want to receive another person's blood for religious or other reasons.
If you anticipate undergoing surgery, you can discuss this pro-cedure with your local haematologist or with the doctor at your specialist Gauchers Centre.
The procedure may not be practical for children under a certain age and a paediatric expert at your child's Gauchers Centre should be consulted on this issue.
Not all hospitals in the UK have the facility to collect a patient's own blood. It requires specialist nurses or doctors to take the blood, separate blood bank fridges and separate issuing fridges.
Risks involved with donating your own blood prior to an operation are:
Reducing the Need for Blood Transfusions
Current thinking focuses on reducing the need for transfusion at the time of surgery. Increasingly surgeons and anaesthetists try to perform surgery without blood transfusion.
A patient should be assessed prior to surgery to detect anaemia or any bleeding tendency (caused by low platelet count or abnormal platelet function) and if possible this should be treated before surgery.
Some surgeons give a platelet transfusion as a matter of course each time a hip replacement is carried out. This new emphasis on reducing blood transfusions may be a more appropriate course than autologous blood transfusion.
There is evidence that surgical patients can tolerate significant degrees of anaemia and that blood transfusion does not always improve the outcome of surgery. A haemoglobin level above 8g/dl is generally considered adequate and may be associated with a lower risk of blood clot formation (thrombosis). Iron therapy and erythropoietin may be useful in the post operative situation.
Patients who need surgery should have a careful pre-operative assessment. Any risk factors for excessive bleeding should if possible be corrected prior to surgery.
If a patient is suitable for autologous blood transfusion, this could be considered. In addition attention regarding bleeding should be given during and after the operation.
Acknowledgements: Dr Atul Mehta and Dr Clare Taylor (Royal Free Hospital), Prof Timothy Cox (Addenbrooke's Hospital), Prof Pram Mistry (Yale Medical School, USA), Dr Ashok Vellodi (Great Ormond Street Hospital for Children,, Dr Ed Wraith and Dr A M Will (Central Manchester and Manchester Children's University Hospitals), Prof Ari Zimran (Shaare Zedek Medical Centre, Israel).
Gauchers News Contents
Source: Gauchers News April 2003.
© Copyright Gauchers Association 2003.