[Need for a pre-deposit autotransfusion program for patients undergoing elective surgery]. / Necesidad de un programa de autotransfusión con predepósito en pacientes sometidos a cirugía programada.

INTRODUCTION: Preoperative autologous hemodonation is a very useful procedure, but it is not exempt from risks. To reduce them we must ascertain the frequency of autologous donation and the amount of blood needed for each intervention. The objective of this work is to know which are the subsidiary interventions of autotransfusion, which are true necessities of blood for them. PATIENTS AND METHODS: All the crossmatched blood units preserved for surgical procedures that might be allocated for autotransfusion were controlled. The source service, the type of intervention, and the number of units requested and transfused were identified. RESULTS: 269 surgical interventions were controlled. For these interventions, 666 units of blood were reserved. No blood transfusion was necessary in 69% of the surgical operations. The number of units transfused was 229 (26.28%). Traumatology and Heart Surgery were the services that demanded more blood. The procedure with greatest requirements of blood units was the total knee replacement. Hysterectomy was the intervention with the lowest percentage of utilization of reserved blood (5.26%). CONCLUSIONS: Autotransfusion should be offered to all patient in need of knee or hip replacement and those who are subjected to heart surgery with extracorporeal circulation. Patients who are programmed for interventions with a low percentage of utilization of blood, should know these findings, in order that they don't feel subjected to unnecessary procedures.

Acute leukemias after treatment with radioiodine for thyroid cancer.

Leukemia is an uncommon complication of exposure to radioiodine (131I), used in treatment of thyroid cancer, because low doses are now used. We report two cases of acute myelogenous leukemia developed after the treatment of a thyroid carcinoma with a small dose of 131I.