Transfusion Therapy - Conservation and Salvage Techniques
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Autologous donation usually begins 6 weeks before surgery and can reduce greatly the amount of homologous blood transfused. The length of the predonation period is limited by the length of time that blood can be stored, currently 42 days unless the blood is frozen. Current blood bank guidelines require a predonation Hb of at least 11 g/dL, donations no more frequently than every 3 days, and no donations in the 72 hours before surgery. Most patients tolerate autologous donation without complication. Patients with severe aortic stenosis or unstable angina are not candidates for autologous donation. Patients donating autologous blood should receive supplemental iron because depleted iron stores frequently limit RBC recovery. Recombinant erythropoietin treatment also may be considered. Because a risk of transfusion reaction exists due to clerical error, autologous blood should not be transfused unless a transfusion is clinically indicated.