The current status of autologous blood transfusion in Japan – The importance of pre-deposit autologous blood donation program and the needs to achieve patient blood management.
The authors conducted a retrospective analysis of their preoperative autologous blood donation (PABD) program compared to their historical control. After implementation of the PABD program, the number of patients donating autologous blood and the number of donated bags increased, especially in the departments of orthopedics, gynecology & obstetrics, neurosurgery and urology. The total number of collected bags increased from 885 in 2000 to 1318 in 2010.
The percentage of patients requiring additional use of allogeneic blood was 11% in 2002 and decreased to 5% in 2003. The rate of wastage of autologous blood was highly different according to preservation method, approximating 30% in the case of frozen preserved RBCs, compred with around 8% for whole blood. The authors also found that the total profit of autologus blood transfusion was about 72,000 dollars in 2000, increasing to 130,000 dollars in 2007, suggesting that autologous blood is superior to allogeneic blood transfusion in terms of hospital costs.
Even though the study was a retrospective, historical control analysis, the PABD program appears to have changed transfusion practice. However, the wastage rate was still quite high and the authors did not analyze clinically important outcomes, such as morbidity and mortality.
– Hiroshi Morimatsu