Adverse events during preoperative autologous blood donation and its usage in obstetrical patients: A multicenter, retrospective survey in Japan.

BACKGROUND

Evaluating the safety of preoperative autologous blood donation (PAD) and its transfusion is important, especially for young pregnant donors in an era of extremely low incidence of viral transmission.

MATERIALS AND

METHODS

Questionnaires were sent to hospitals, and safety information from donation to transfusion was collected and analyzed.

RESULTS

Among 2378 obstetrical donors who underwent PAD, 1664 received autologous blood only (autologous group), 146 received allogeneic blood in addition to autologous blood (allogeneic group), and 568 received no transfusion (no transfusion group). Two hundred one of the 2378 patients (8.5 %) experienced adverse events (AEs) during PAD and its transfusion, although most AEs were mild. Even in the no-transfusion group, 8.1 % of patients experienced some AEs. The vasovagal reaction (VVR) rate was 2.6 % (n = 63). Other AE associated with donation developed in 114 patients (4.8 %), and they were the main components of all AEs; 32.5 % of them were unique to obstetric patients. Obstetrical donors with PAD may have disadvantages compared to donors with PAD in other settings. Transfusion reactions (TRs) occurred in 29 (1.2 %) patients. Surprisingly, the number of patients with TRs per unit did not differ significantly between the autologous and allogeneic groups.

CONCLUSION

Considering that most AEs occurred due to donation, PAD in obstetric patients was not beneficial. Moreover, similar TRs rates between the autologous and allogeneic groups did not indicate the priority of autologous blood. PAD should be performed by using a well-established transfusion management system.