Comparison of the efficacy of autologious blood transfusion combined with preoperative hemodilution, with homologous blood transfusion in patients undergoing elective surgical procedure

Sanjay Saksena, Namrata Jain, Alok Dixit


Background: To study the changes in haemogram and coagulation profile in patients undergoing autologous and homologous blood transfusion and suitability of the technique of autologous blood transfusion in routine blood bank management.

Methods: Patients who were waiting to undergo elective surgical procedures were randomly distributed in two groups, Group A:  Autologous blood transfusion, with or without haemodilution: wherein pre-operative period a predicted volume of blood was collected and Group B: Homologous blood transfusion: where required blood was arranged from Blood Bank. The cardiovascular status, the haemogram and the coagulation profile were recorded at various stages.

Results: Out of 240 patients registered only 43 could fulfil the basic requirements only 25 could be motivated in each group. In Group A cases were of age group 51-60 years while it was 41-50 years in Group B. Male:Female ratio was 2:1. 47 Units were retransfused to Group A patients, Group B cases received 45 blood transfusions. In Group A patients 8% cases showed mild hypotention and 1% showed mild hypersensitivity to Haemacel. In Group B, 40% cases showed transfusion reactions. Fall in Hb was lesser in Group A (2.4) on first and (1.7) on second postoperative day compared to Group B (3.3) on first and (2.7) on second postoperative day. The haematocrit levels declined more sharply after operation in Group B (7) rather than Group A (10.4).

Conclusions: Advantage of avoiding transfusion reactions, major changes in blood parameters, entry of infections proves Autologous blood transfusion to be the safest, cost effective and easy form of transfusion therapy.


Autologous blood transfusion, Homologous blood transfusion Haemodilution

Full Text:



Chalfin HJ, Frank SM, Feng Z, Trock BJ, Drake CG, Partin AW, et al. Allogeneic versus autologous blood transfusion and survival after radical prostatectomy. Transfusion. 2014;54:2168-74.

Tesic I, Sekulic J, Arbutinov V, Popov D, Velisavljev D. Autologous blood transfusion in patients undergoing hip replacement surgery. Med Pregl. 2014;67:101-7

Dietrich W, Thuermel K, Heyde S, Busley R, Berger K. Autologous blood donation in cardiac surgery: reduction of allogeneic blood transfusion and cost-effectiveness. J Cardiothorac Vasc Anesth. 2005;19:589-96.

Tsuno NH, Nagura Y, Kawabata M, Matsuhashi M, Sone S, Ikeda T, et al. 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. Transfus Apher Sci. 2013;49:673-80.

Klein HG. Allogeneic transfusion risks in the surgical patient. Am J Surg. 1995;170(6A) Suppl:21S-6S.

Goodnough LT, Brecher ME, Kanter MH, AuBuchon JP. Transfusion medicine. Second of two parts--blood conservation. N Engl J Med. 1999;340:525-33.

Karkouti K, McCluskey S. Pro: Preoperative autologous blood donation has a role in cardiac surgery. J Cardiothor Vasc Anest. 2003;17:121-5.

Xu YA, Zhang J, Zhou AG. Clinical study of predeposit autologous transfusion in total knee replacanent. J Traumatic Surg. 2009;11:331-3.

Jakovina Blazekovic S, Bicanic G, Hrabac P, Tripkovic B, Delimar D. Pre-operative autologous blood donation versus no blood donation in total knee arthroplasty: a prospective randomised trial. Int Orthop. 2014;38:341-6.

Long MY, Liu ZH, Zhu JG. Comparative analysis of autologous blood transfusion and allogeneic blood transfusion in surgical patients. Int J Clin Exp Med. 2014;7:2889-94.

Martin K, Keller E, Gertler R, Tassani P, Wiesner G. Efficiency and safety of preoperative autologous blood donation in cardiac surgery: a matched-pair analysis in 432 patients. Eur J Cardiothorac Surg. 2010;37:1396-01.

Kapadia BH, Banerjee S, Issa K, McElroy MJ, Harwin SF, Mont MA. Preoperative blood management strategies for total knee arthroplasty. J Knee Surg. 2013;26:373-7.

Barbara HD, Susanne A, Julian S, Reinhold E, Robert Z. Prevention and management of transfusion-induced alloimmunization: current perspectives. Int J Clinical Trans Med. 2014;2:59-63.

Birkmeyer JD1, Goodnough LT, AuBuchon JP, Noordsij PG, Littenberg B. The cost-effectiveness of preoperative autologous blood donation for total hip and knee replacement. Transfusion. 1993;33:544-51.

Newman JH, Bowers M, Murphy J. The clinical advantages of autologous transfusion. A randomized, controlled study after knee replacement. J Bone Joint Surg Brit. 1997;79: 630-2.

Spark JI, Chetter IC, Kester RC, Scott DJ. Allogeneic versus autologous blood during abdominal aortic aneurysm surgery. Eur J Vascular Endovasc Surg, 1997;14:482-6.

Heiss MM, Mempel W, Jauch K-W, Delanoff C, Mayer G, Mempel M, Eissner H-J, Schildberg F-W. Beneficial effect of autologous blood transfusion on infectious complications after colorectal cancer surgery. Lancet. 1993;342:1328-33.

Murphy P, Heal JM, Blumberg N. Infection or suspected infection after hip replacement surgery with autologous or homologous transfusions. Transfusion. 1991;31:212-7.

Mezrow CK, Bergstein I, Tartter PI. Postoperative infections following autologous and homologous blood transfusions. Transfusion. 1992;32:27-30.

Triulzi DJ, Vanek K, Ryan DH, Blumberg N. A clinical and immunologic study of blood transfusion and postoperative bacterial infection in spinal surgery. Transfusion. 1992;32:517-24.

Fernandez MC, Gottlieb M, Menitove JE. Blood transfusion and postoperative infection in orthopedic patients. Transfusion, 1992; 32: 318-322.

Howard HL, Rushambuza FG, Martlew VJ, Satchi G, Bolton-Maggs B. Clinical benefits of autologous blood transfusion: an objective assessment. Clin Lab Haematol, 1993;15:165-71.

Busch ORC, Hop WCJ, Hoynck van Papendrecht MAW, Marquet RL, Jeekel J. Blood transfusions and prognosis in colorectal cancer. New Eng J Med. 1993;328:1372-76.