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Chapter 107. Transfusion Biology and Therapy (Part 10)

Alternatives to Transfusion Alternatives to allogeneic blood transfusions that avoid homologous donor exposures with attendant immunologic and infectious risks remain attractive. Autologous blood is the best option when transfusion is anticipated. However, the cost:benefit ratio of autologous transfusion remains high. No transfusion is a zerorisk event; clerical errors and bacterial contamination remain potential complications even with autologous transfusions. Additional methods of autologous transfusion in the surgical patient include preoperative hemodilution, recovery of shed blood from sterile surgical sites, and postoperative drainage collection. . | Chapter 107. Transfusion Biology and Therapy Part 10 Alternatives to Transfusion Alternatives to allogeneic blood transfusions that avoid homologous donor exposures with attendant immunologic and infectious risks remain attractive. Autologous blood is the best option when transfusion is anticipated. However the costbenefit ratio of autologous transfusion remains high. No transfusion is a zerorisk event clerical errors and bacterial contamination remain potential complications even with autologous transfusions. Additional methods of autologous transfusion in the surgical patient include preoperative hemodilution recovery of shed blood from sterile surgical sites and postoperative drainage collection. Directed or designated donation from friends and family of the potential recipient has not been safer than volunteer donor component transfusions. Such directed donations may in fact place the recipient at higher risk for complications such as GVHD and alloimmunization. Granulocyte and granulocyte-macrophage colony-stimulating factor are clinically useful to hasten leukocyte recovery in patients with leukopenia related to high-dose chemotherapy. Erythropoietin stimulates erythrocyte production in patients with anemia of chronic renal failure and other conditions thus avoiding or reducing the need for transfusion. This hormone can also stimulate erythropoiesis in the autologous donor to enable additional donation. Further Readings Blajchman MA The clinical benefits of the leukoreduction of blood products. J Trauma 60 S83 2006 Brecher ME Hay SN Bacterial contamination of blood components. Clin Micro Rev 18 195 2005 PMID 15653826 ------et al The Technical Manual 15th ed. Arlington VA American Association of Blood Banks 2005 Busch MP et al A new strategy for estimating risks of transfusion transmitted viral infections based on rates of detection of recently infected donors. Transfusion 45 254 2005 PMID 15660836 Raghavana M Marik PE Anemia allogeneic blood transfusion and .