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Objective To investigate the effect of allogeneic transfusion and preoperative autologous blood donation on perioperative cellular immunity and humoral immunity in patients with gastrointestinal neoplasms.Methods Sixty gastrointestinal cancer patients undergoing radical surgery,33 males and 27 females,aged 53 69 years,weighing 47-70 kg,ASA physical status Ⅰ or Ⅱ,were included in this study.Blood transfusion was started when the blood loss was more than 200～400 ml,Hb＜70 g/L,and the patients were randomly divided into the preoperative autologous blood donation group (group P,n =30):intraoperative blood transfusion using the stored autologous blood transfusion;allogeneic blood transfusion group (group A,n =30):allogeneic blood transfusion.The levels of T lymphocyte subsets,NK cells and IL-2,IL-10,TNF-α,perforin (PF) concentration and plasma immunoglobulin IgG,IgA and IgM levels.Results The percentage of CD3+,CD4+,NK cells and the ratio of CD4+/CD8+ in group A at the end of surgery to 7 d after operation were significantly lower than those at the time of admission (P＜0.05).The percentage of CD3+,CD4+ (P＜ 0.05).The level of IL-2 in group A was significantly lower than that in group P (P＜0.05) 1-7 d after operation,and the level of IL-10 in group A was significantly higher than that in group P (P＜ 0.05).The levels of IgG and IgA 3 d after operation in group A were significantly lower than those in group P (P＜0.05).The levels of IgG and IgA in group P were significantly decreased at the end of operation and recovered to preoperative levels 1-3 d after operation (P ＜ 0.05).Conclusion Allogeneic blood transfusion can reduce the percentage of T-cell subsets and NK cells in cancer patients and delay their recovery,and also can transiently reduce the content of immunoglobulin IgG and IgA in plasma and thus affect the immune function of patients.However,the preoperative autologous blood donation has a slight effect on postoperative immune function in cancer patients.
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Objective To investigate the application of preoperative autologous blood donation (PABD) in selective operation.Methods Retrospective investigations and analysis were carried out in clinical datas of 1 026 patients of PABD in selective operation from January 2016 to may 2017,comparing with those who had not performed PABD in the same time.Results ①The surgeries of PABD were mainly neurosurgery,urology,orthopedics,gynecology and hepatobiliary surgery,respectively,which accounted for 5.97％,4.90％,3.78％,3.76％ and 3.55％ of the patients in the same period;②The rate of transfusion of allogeneic red blood cells of selective operation in PABD group of neurosurgery,urology,orthopedics,gynecology and hepatobiliary surgery were 5.66％,2.51％,4.89％,0 and 4.88％,respetively,while not performed PABD group were 25.46％,28.58％,24.77％,10.62％ and 17.54％,respetively;③The rate of transfusion of the group of hemoglobin (Hb)＜ 120 g/L is significantly higher than those Hb is (120-129.9) g/L,(130-139.9)g/L and ≥ 140 g/L(7.65％vs 2.44％,3.66％ and 2.70％,P＞0.05).Conclusion ①PABD is mainly carried out in neurosurgery,urology,orthopedics,gynecology and hepatobiliary surgery;②The group of Hb＜ 120 g/L has a high rate transfusion of allogeneic erythrocyte in selective operations;③Only the PABD is improved can patients make benefit from it.
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Objective To explore the effect of predepositautotransfusion in hematopoietic stem cell donors.Methods 127donors of hematopoietic stem cell wereretrospectively analyzed from 2013 to 2016,whenhematopoietic stem cells collection and autologous blood transfusion.Results Collection autologous blood 70 550 mL by 127 donors,and 2 cases had mild blood donation reaction,at a rate of 1.6％ (2/127).Collectionbone marrow stem hematopoietic stem cell 100 159 mL.The detection results were WBC (27.02±8.21) × 1010/L、Plt(213.19±62.42) × 109/L、RBC(4.31±0.44) × 1012/L、Hb(131.53 t14.53)g/L,from 117 donors beforespinal cord extraction.The detection results were WBC (35.8519.08)× 1010/L、Plt (188.34±50.24) × 109/L、RBC (4.02± 0.41) × 1012/L、Hb (122.60 ± 13.48) g/L,from 117 donorsafter autologous blood transfusion in one day.Compared with donors after autologous blood transfusion in one day,WBC was higher before spinal cord extraction(P＜0.05),Plt RBC and Hb was significantly decree (P＜0.05).Conclusion Preoperative autologous blood donation can save blood and prevent blood-borne infectious disease,which can used in Hematopoietic stem cell donor.
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Autologous blood transfusion (ABT) has been gradually attracting more attention due to the increasingly prominent problem of blood transfusion safety and blood shortage in recent years. With the rapid development of blood conservation techniques, blood component separation technology, blood transfusion medicine and a constant increase in clinical needs, ABT technology has been expanded and innovated to a large degree. In this study, the development of preoperative autologous blood donation (PABD), acute normovolemic hemodilution (ANH), intraoperative and postoperative autotransfusion, and other new technologies and theories are reviewed and existing questions are analyzed. Challenges and applications are also discussed in order to provide reference for peers.
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Humans , Blood Transfusion, Autologous , Hemodilution , Perioperative CareABSTRACT
Objective To provide reference for the clinical application of preoperative autologous blood donation(PABD).Meth-ods 34 patients met the conditions of PABD,and underwent PABD were enrolled in the study.Five laboratory indicators include Hemoglobin(Hb),RBC,WBC,PLT)and hematocrit(HCT),and prepared blood volume before surgery,intraoperative and postop-erative reinfusion volume were recorded before blood collection and after reinfusion.Results In the patients who only underwent PABD(A group),compared between before blood collection and after blood transfusion(intraoperative or postoperative 24 h),all the five Hematology Index were statistically different(P 0.05).Con-clusion The effective of PABD application in surgical patients undergoing elective operation is good,which won′t cause harm to the patient′s body(reflected in the hematology indicators).However,in some cases preoperative assessment of blood loss is not accurate enough,result in the amount of blood collected before operaton not meeting the needs,which might impact the effect PABD.
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Objective Preoperative autologous blood donation ( PABD) may reduce the need for allogeneic blood , but it may also cause a short massive blood loss in pregnant women , and its fetal and maternal safety has to be adequately assessed .This study was to evaluate the feasibility and safety of PABD for pregnant women and their fetuses . Methods A prospective observational study was conducted among the women who met the inclusion criteria and gave birth in Nanjing Drum Tower Hospital between January and December 2013 .According to the clinical validation of risk stratification criteria for peripartum hemorrhage of California 2013 , the ca-ses were classified into a low-, a medium-, and a high-risk group.Data on blood donation procedures , obstetric outcomes, and blood transfusions were collected after delivery for analysis . Results Totally, 92 pregnant women accomplished 115 blood donations .The median volumes of the donated blood were 300, 300, and 400 mL in the low-, medium-, and high-risk groups, respectively ( P>0.001).There were no significant changes in HR , SBP and SpO2 during the blood donation procedures (P>0.05) except for the fall of diastolic blood pressure by an average of 3.4 mmHg (P0.05), which were similar to those in the cases who donated twice , with no significant differences before and after the donation (P>0.05). Homologous blood transfusion was performed for 5 cases (17.9%) in the high-risk group, with the volume of blood loss >2000 mL in all the cases.All the newborns survived without asphyxia and there was no perinatal death . Conclusion PABD can provide timely autologous whole blood donation for pregnant women .Under strict management , PABD is feasible and safe for pregnant patients who are at a high risk for massive blood loss during delivery or have a rare type of blood no readily available .
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BACKGROUND: Major orthopedic surgical procedures, including spinal fusions, require 2 or 3 units of transfusion. In this study, we evaluated the usefulness of autologous transfusion by comparing the postoperative infections, the pre- and postoperative serological changes, the amount of transfusion during the operation and the segmented estimated blood loss of the patients who received spinal fusion surgery. METHODS: We analyzed 106 patients who were undergoing spinal fusion surgery and among them, 69 patients were operated on with using autologous transfusion, while 37 cases were operated on with using homologous transfusion. RESULTS: The segmental estimated blood loss was approximately 574.4+/-131.8 mL in group 1 and 635.3+/-250.1 mL in group 2. The mean number of transfused units in the autologous transfusion group was 2.1+/-0.3 units and this was 3.5+/-0.6 units in the homologous transfusion group. There was no significant statistical difference in the hemoglobin level or the complications between the two groups, yet the duration of fever in the group with homologous transfusion was 3.0+/-0.4 days, which was increased compared to that of group 1 (1.4+/-1.3 days). CONCLUSION: The total amount of transfusion and blood loss for the patients who were operated on using autologous transfusion were less, as compared to those for the patients who were operated on with homologous transfusion, and the patients with homologous transfusion showed a significantly decreased duration of fever. It seems that autologous transfusion is a way to shorten the duration of fever and increase the satisfaction of the patients.
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Humans , Blood Donors , Fever , Hemoglobins , Orthopedic Procedures , Spinal FusionABSTRACT
BACKGROUND: Preoperative autologous blood donation is utilized to reduce the risk of transfusion associated infections and transfusion reactions using homologous blood. We analyzed our experiences of autologous blood donations in Kyung Hee University Hospital. METHODS: From Jan. 1996 to Feb. 1997, we analyzed 213 patients who visited the blood donation room for autologous blood donation. RESULTS: Among 213 patients, 32 patients(15%) were rejected because of unfittedness with donor criteria. The majority of donor were orthopedic patients(95.4%). 14 patients(8%) could not finish the donation during the blood collection period because of donor reaction. The major cause was anemia(6 cases, 43%). During the donation period, mean of hemoglobin level was decreased by 1.3g/dL. Less than 1.5g/dL of hemoglobin reduction was observed in 117 patients(64.6%). In the use of donated blood, 43% used only autologous blood, 40.5% used autologous blood and additional homologous blood, and 16.5% were diacarded. The seropositive rates of HBsAg, anti-HCV, anti-HIV, and VDRL were 7%, 0.6%, 0%, and 0.6%, respectively. Simultaneously seropositive rate of HBsAg & anti-HCV was 0.6%. CONCLUSION: Autologous blood donation can be a good transfusion practice for elective surgery. Physician education programs are needed to avoid necessary homologous blood and unnececessary autologous blood donation.