What is the process for autologous (self) blood donation?

Autologous Blood Donation Process

Autologous blood donation involves collecting a patient's own blood before elective surgery for later reinfusion, with patients able to donate one unit (450 ± 45 ml) as frequently as twice weekly up to 72 hours before the procedure. 1

Patient Selection Criteria

Proceed with autologous donation only when:

• The planned surgery has expected blood loss >20% of total blood volume 2
• Preoperative hemoglobin is ≥110 g/L 2
• The patient has rare blood type, multiple red cell antibodies, or strong preference to avoid allogeneic transfusion 2

Exercise extreme caution or exclude patients with:

• Moderate to severe left ventricular impairment 2
• Unstable angina or critical left main stem disease 2
• Severe aortic stenosis 2
• Active bacterial infection or malignancy (relative contraindication) 2

Collection Protocol

Blood collection must follow these specifications:

• Use licensed blood collection packs with CPD-A1 anticoagulant (450 ml ±10% or 250 ml ±10% packs) 2
• Clean skin thoroughly with chlorhexidine in alcohol 2
• Clamp donor tubing before removing needle guard to prevent air contamination 2
• Agitate pack gently throughout collection to mix blood with anticoagulant 2
• Use regularly calibrated balance to measure exact volume collected 2
• Seal bleed line with clips or heat sealer at cut end and close to pack 2

Labeling Requirements

Every unit must be labeled with: 2

• Patient's full name, hospital number, and date of birth
• Date and time of collection
• Name of person performing collection
• Clear statement: "UNTESTED BLOOD: FOR AUTOLOGOUS USE ONLY"

Storage and Handling

Critical storage parameters include:

• Blood remains with the patient at all times; never transfer to blood bank refrigerator 2
• Store at room temperature for maximum 6 hours in insulated container 2
• Label container with patient details and warning against use for other patients 2
• Blood from patients with viral markers (HIV, HBV, HCV) must not leave theatre unless infusion commenced 2

Timing and Frequency

Donation schedule:

• Patients may donate up to twice weekly 1
• Final donation must occur at least 72 hours before surgery 1
• For optimal results, consider 1-2 weeks before surgery to allow hemoglobin recovery 3

Documentation

Mandatory records include: 2

• Number of units and total volume collected in patient's case notes
• If allogeneic blood is given, clearly document reasons in notes
• All serious adverse events reported to hospital transfusion committee

Consent Process

Informed consent must address: 4

• Explanation of why transfusion is needed and specific benefits
• Individualized risks including transfusion reactions and infections
• Available alternatives including cell salvage
• Documentation of patient's agreement and questions asked

Common Pitfalls to Avoid

• Do not collect autologous blood for minor procedures where transfusion is unlikely 5 - this wastes resources and exposes patients to unnecessary risks
• Do not automatically transfuse collected blood simply because it is available 2 - base the decision on actual clinical need
• Do not screen patients for viral markers 2 - this is unnecessary for autologous donation but maintain universal precautions
• Never allow autologous blood to enter general blood supply 2 - dispose unused units as hazardous waste

Disposal

Unused autologous blood must be: 2

• Disposed as hazardous waste, preferably in theatre
• Fate of all units documented
• Never transferred to general blood supply per local standard operating procedures