Preoperative Autologous Blood Donation a Confessors Point Of View

This contribution was part of a public pro and con discussion during the 4th CAT symposium in Nottwil (Switzerland) and will focus predominantly on the pro arguments for preoperative autologous blood donation (PABD). A major advantage of PABD is the avoidance of the immunological problems associated with allogeneic transfusions. These can result in the delay of later transfusions and unavailability of compatible blood after immunization, leading to severe hemolytic transfusion reactions when red cell antibodies cannot be taken into account. Arguments will be presented that clearly show that transfusion of the wrong patient is expected less frequently with autologous blood products as long as general transfusion standards are observed. Unavoidable delayed hemolytic transfusion reactions, which occur after boostering of an undetectable antibody produced after an immunization in the past, cannot happen when autologous blood is administered. Furthermore, despite comprehensive testing for infectious diseases, allogeneic blood still bears the risk of transmission of infections due to blood donation in the window period, low-carrier status of the blood donor, or the emergence of new infectious agents. However, PABD should be adapted to the individual transfusion need of a patient for a given surgical intervention, should be carried out under optimized conditions, and should be included in a comprehensive concept of autologous hemotherapy. As part of such a concept, PABD constitutes a key element because it is, in contrast to other techniques, a preventive measure. Schlüsselwörter Präoperative Eigenblutspende · Autologe Hämotherapie · Bluttransfusion