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IMPROVE PROTOCOL TO AUTOLOGOUS PREDONATION (APD) PROGRAMME IN MAJOR ORTHOPEDIC SURGERY

P-23. Sáez M, *Sánchez-Vizcaino E, Balagué S, Serra A, Dalmau C , Izquierdo I, Sánchez MI, Montero A, Escrich S, Vilá E, Ribas E, **González-Adrio R, Madoz P. Banc Sang i Teixits . Barcelona. Sant Pau. *Laboratorio Echevarne. **Servei Traumatologia, Clínica CIMA, Barcelona. Spain.

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IMPROVE PROTOCOL TO AUTOLOGOUS PREDONATION (APD) PROGRAMME IN MAJOR ORTHOPEDIC SURGERY

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  1. P-23 Sáez M, *Sánchez-Vizcaino E, Balagué S, Serra A, Dalmau C, Izquierdo I, Sánchez MI, Montero A, Escrich S, Vilá E, Ribas E,**González-Adrio R, Madoz P. Banc Sang i Teixits. Barcelona. Sant Pau. *Laboratorio Echevarne. **Servei Traumatologia, Clínica CIMA, Barcelona. Spain. INTRODUCTION In 2004 a private clinic began to send patients to our Blood Centre who were included in the Autologous Predonation (APD) Programme. Our Blood Centre has improved this programme on the donation rate in order to optimise its cost-effectiveness and therefore achieve an adequate blood supply to our clients (patients and physicians). METHODS From 2004 to 2009 a total of 253 patients were scheduled for a single Birmingham resurfacing hip prosthesis and 3 for a bilateral prosthesis, 198 male and 47 female, were enrolled in the APD programme.The average age was 51.31 + 11.1 years (range 16-77). RESULTS IMPROVE PROTOCOL TO AUTOLOGOUS PREDONATION (APD) PROGRAMME IN MAJOR ORTHOPEDIC SURGERY From January 2004 to April 2006 we scheduled 91 patients and 181 autologous units (2 units /patient) and 1 double erythroaferesis were collected. Four patients needed allogenic blood units and 168 autologous units were transfused. The average haemoglobin levels aftersurgery was high enough (116.7 + 9.9 g/L), so our first strategy was to reduce the number of APD units collected. We did so, and it didn’t increase allogenic transfusions. From May 2006 to December 2007 122 patients, 101 male and 21 female, were scheduled and 123 APD were collected (1.01 unit/patient). There were five allogenic and 115 autologous transfusions. The average haemoglobin level after surgery in this group of patients was 104.5 + 10 g/L. A second strategy was approached to reduce the great number of autologous transfusions: as most of patients (94) had haemoglobin levels >140 g/L before APD, it made autologous donation and transfusion not necessary. In the last two years only 16 male and 18 female were enrolled in APD programme and collected 36 APD units. Two patients needed allogenic transfusion but the number of autologous transfusional requirements was reduced to 32 units. This strategy not only improved patient comfort and reduced costs, but it also maintained the average haemoglobin in safety levels of 98.4 + 10 g/L. CONCLUSION The surveillance and follow-up of APD programmes has permitted a reduction in autologous transfusions, without increasing allogenic transfusions, avoiding blood waste of means, improving quality and cost-effectiveness ratio, as well as increasing patient safety.

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