I have been working with my orthopedic physicians who perform total joints and have been very successful in drastically reducing autologous donations and transfusions. There is a good article in the Journal of Bone and Joint Surgery July 2004 by Tim Hannon with an alogrithm that I modified a little but works. We collect all of their auto units and I showed the physicians their own pt data and also provided them with info about lowering the transfusion trigger. I also took a big step and changed our criteria for auto donation. Auto donors must complete their donations with in 21 days of surgery and I increased the hgb requirements. So far no complaints. My next group to work with are the spine surgeons.
