What is Autologous Blood Transfusion?

There are two broad categories of blood transfusion, allogeneic and autologous. In allogeneic blood transfusion, the patient is transfused with blood (or blood components) donated by somebody else (be it an unknown volunteer donor or a friend or a family member). In autologous blood transfusion (a.k.a. auto-transfusion), the patient is both the donor and the recipient of the donated blood. In other words, in autologous transfusion, the patient is transfused with his own blood (or blood components).

Transfusion of blood and blood products is the therapeutic option of choice in many medical emergencies and planned surgical procedures. Blood transfusion saves lives. On the other hand, a transfusion is not an inconsequential clinical practice. However minuscule, there is always the possibility of side effects and adverse reactions to the transfused blood: Bacterial contamination, viral infections, febrile reactions, allergic sensitization, and compatibility errors are some of the things that can go wrong every time a unit of blood is transfused. The risk of side effects is reduced by strict criteria for donor selection and screening of the donated blood. However, the time-honored mantra holds true: The safest blood transfusion is the one never given.

Autologous blood transfusion is regarded as a safer alternative to allogeneic transfusion. It is not a new practice, but it did become increasingly popular in the late eighties and nineties, following the AIDS crisis and the discovery of the hepatitis C virus. Since then, more and more patients have opted for autologous transfusions.

The patient who wishes to receive autologous transfusions, needs to meet certain requirements. For example, he needs to be scheduled for surgery that is expected to involve an amount of blood loss that warrants a transfusion. The patient also needs to pass a health screening, similar to that of a volunteer donor, but less stringent in certain respects. If the patient is eligible for autologous donation, he must give blood weekly in a time-frame of four to six weeks and no later than 72 hours before the day of the surgery. Adequate time must be allowed for the regeneration of the patient's red blood cells before the surgery.

Autologous blood donation and transfusion is a highly specialized sector in the field of blood transfusion practice. There are several options available (preoperative autologous blood donation, intra- or postoperative blood salvage, acute normovolemic hemodilution) that the patient/autologous donor needs to discuss with his physician. Each option is appropriate for a specific set of surgical procedures and involves a variety of special considerations, selection criteria, blood collection and storage techniques, advantages, as well as potential risks. The patient needs to be made aware of these well in advance of the scheduled procedure.

If you are scheduled for major surgery (e.g. hip replacement, coronary artery bypass), you may want to talk to your surgeon about autologous blood donation. For information on the various options and techniques, http://www.nhlbi.nih.gov/health/prof/blood/transfusion/logo.htm is a good place to start.