Objective: We assessed the current role of preoperative and intraoperative autologous blood donation in pediatric open-heart surgery.
Methods: Group 1 consisted of 51 patients between 5 and 10 years old who underwent preoperative autologous blood donation. Group 2 consisted of 50 age-matched patients without preoperative donation as controls. Intraoperative donation was conducted in both groups prior to cardiopulmonary bypass. We evaluated perioperative blood cell count, blood loss, and the need for homologous blood products.
Results: No serious complications occurred in preoperative or intraoperative donation. Total preoperative donation storage was 17.5 +/- 3.4 mL/kg. Intraoperative donation was 21.7 +/- 6.1 mL/kg in Group 1 and 12.8 +/- 4.0 mL/kg in Group 2 (p < 0.001). On admission, serum hemoglobin was lower in Group 1 (12.2 +/- 1.0 g/dL versus 13.6 +/- 1.6 g/dL, p < 0.001) but returned postoperatively to the preoperative value. It hovered at a depressed level in Group 2 (12.2 +/- 1.4 versus 10.2 +/- 1.1 g/dL, p < 0.001). The homologous blood requirement was significantly less in Group 1 than in Group 2 (0% versus 10%, p < 0.05). Postoperative platelet counts showed similar curves, and blood loss was not statistically significantly different between groups.
Conclusion: Preoperative and intraoperative donations are safe and continue to contribute uniquely to blood conservation, providing important options in comprehensive blood conservation programs in current pediatric open-heart surgery.