How many no longer using pre-deposit autologous blood

[Mabel Adams]

Of US hospitals between 80 & 400 beds how many of you are no longer using any significant quantity of pre-deposit autologous blood? Why?

If you are still using it a lot, why?

[Mary**]

We are a 235 bed hospital and use less than 6 units a month.

[Deny Morlino]

120 bed hospital and it is rare to see autologous show up here once per year from the supplier. I think the confidence in the blood supply has increased for one thing. The other is the doubt some of the physicians have about using stimulators to boost the bone marrow prior to surgery. These are just opinions and do not reflect the beliefs of any physician at our facility.

[KKidd]

We have not seen an autologous unit for over 5 years. I don't beleive the surgeons are pushing it.

[L106]

We are a 300 bed hospital. About 10 years ago we started drawing autologous donor units one a week (for the convenience of our patients and surgeons who were requesting this service.) At its height of its "popularity", we often had 15 to 17 autologous donors per week. (ie: 60 autologous units a month!) Probably over half of the units were not used.

Then one of our orthopedic surgeon started paying attention. He came to the conclusion that those patients who donated one or two autologous donor units always seemed to need a transfusion of one of their autologous units a couple days after surgery. And his patients who did not donate any autologous units rarely every needed a transfusion. (Gee! Imagine that!)

Word spread, and our collections eventually tapered off to only one unit every month or so. So we stopped drawing autologous units this year. We still receive about one unit a month collected by our blood supplier.

I think this decline among our service area is a combination of improved safety of the volunteer blood supply (and the evidence that the expense and extra time & effort of the autologous donations was not resulting with any extra benefit to the vast majority of patients.)

[Likewine99]

We are a 435 bed Level II trauma center and moved away from autologous blood about 3 years ago. The decision was based on data that showed that we wasted about 60% of the units which cost the organization quite a bit of money and that our transfusion triggers were lowered to hgb of 7.0 or less.

Most of the autos ordered were from the Orthopedic docs and our Medical Director along with our blood supplier were able to provide them with data that backed up the theory that drawing auto units did not benefit the patient.

[AMcCord]

We are 189 beds. Historically, almost all of our autologous units were for orthopedic patients. We now receive 1-2 units from 1-2 individuals per year. They are always orthopedic patients and I think that they are always at the request of the patient, when the surgeon can't talk them out of it (though how hard they try to talk them out of it, I don't know). I think that the surgeons here also came to realize that they were transfusing patients principally because they were autologous donors. They were also provided with information on the percentage of wasted autologous units - about 60-70%. Those guys with 15+ hgbs pre-op never seemed to need a transfusion - Hmmm? why do you suppose that is?! No rocket science there. I think another factor might be that those kinds of surgical cases are being done with new and improved methods/techniques. The patients just don't lose as much blood in the OR or post-op. The physicians are also transfusing much less based on numbers and more on symptoms. If the patient is doing fine with physical therapy on a lowish hemoglobin, they don't transfuse.

Edited September 16, 2011 by AMcCord

[Mabel Adams]

Most of the autos ordered were from the Orthopedic docs and our Medical Director along with our blood supplier were able to provide them with data that backed up the theory that drawing auto units did not benefit the patient.

[EDibble]

We have seen a dramatic drop in Auto units here. When we do get one from ARC our reaction is, "Wow! An Autologous unit!" That being said, I don't know exactly why this has happened, but I suspect that the docs have realized that it does not usually benefit the patient, and as others have also said, there is better confidence in the safety of the blood supply.

[dgibaud]

We are a 250bed hospital and we used to draw almost 1000 units auto, back in the 1990's. We gave up doing that and now only receive the random auto from our supplier from a patient that just can't be convinced that there really isn't any medical advantage anymore.

Don

[GilTphoto]

We are a 200 bed hospital. Haven't seen an autologous unit in 4 years.

2 directed in 4 years