Autologous blood therapy

Autologous blood therapy (ABT), also known as autologous blood transfusion, is a medical procedure that involves collecting and reinfusing the patient's own blood. This technique is employed to reduce the need for allogeneic blood transfusions, where blood from a donor is used. Autologous blood therapy is considered in situations where a significant blood loss is anticipated, such as during surgery, or in treating conditions that lead to anemia. This approach minimizes the risk of blood-borne infections, allergic reactions, and immunological reactions associated with donor blood transfusions.

Overview

Autologous blood therapy can be divided into several techniques, including preoperative blood donation, acute normovolemic hemodilution, and intraoperative and postoperative blood salvage.

• Preoperative blood donation involves the patient donating their own blood weeks before an elective surgery. This blood is then stored and available for transfusion back to the patient if needed during or after surgery.
• Acute normovolemic hemodilution is a process where blood is drawn from the patient just before surgery and replaced with an intravenous solution to maintain blood volume. The collected blood is then returned to the patient to replace blood lost during surgery.
• Intraoperative blood salvage refers to the collection and reinfusion of blood lost during surgery. This is typically done using a cell saver machine that filters and washes the blood before it is returned to the patient.
• Postoperative blood salvage is similar to intraoperative salvage but occurs after surgery, collecting blood from drains placed in surgical sites.

Benefits

The primary benefit of autologous blood therapy is the reduction in the risk of transfusion-transmitted infections and immunological reactions. Since the blood reinfused is the patient's own, it is naturally compatible, reducing the risk of allergic reactions and alloimmunization. Additionally, it helps conserve the blood supply, making more allogeneic blood available for those who need it.

Risks

While autologous blood therapy is generally considered safe, it is not without risks. These include the potential for bacterial contamination of the blood, especially in postoperative blood salvage, and the risk of administrative errors leading to the transfusion of the wrong blood. There is also the risk of over-collection leading to anemia before the surgery.

Indications

Autologous blood therapy is indicated for patients undergoing surgeries with expected significant blood loss, patients with rare blood types or antibodies that make finding compatible donor blood difficult, and patients who refuse blood transfusions for personal or religious reasons.

Contraindications

Contraindications include conditions where the risks of blood collection outweigh the benefits, such as in patients with severe anemia, cardiovascular instability, or infection at the proposed collection site.

Conclusion

Autologous blood therapy offers a viable alternative to allogeneic blood transfusions, with benefits that include reduced risk of transfusion-related complications and conservation of the blood supply. However, it requires careful planning and consideration of the risks and contraindications.

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