This section describes the principles under which the Australian Red Cross Blood Service will participate in a predeposit autologous blood collection, and the rationale for our recommendations.
Introduction
Autologous blood collection is a process of collecting a patient's own blood prior to an elective procedure where it is anticipated there is a likelihood the patient would require a blood transfusion. This is aimed at minimising the potential use of homologous blood (blood from a voluntary donor). Autologous blood collection may also be medically indicated in other circumstances, such as for patients with a known rare blood group.
While it is commonly perceived that autologous transfusion removes the risk of transfusion-transmissible infection, in Australia the overall safety of autologous blood transfusion is not significantly different from homologous transfusion. Risks still exist with autologous blood, such as bacterial contamination, clerical error, degradation effects of blood storage and increased chance of receiving a blood transfusion.
The process of autologous blood collection is the same as for normal blood donation with the same small risks normally associated with giving blood.
Surgery, healing and blood collection all deplete iron body stores. Therefore, iron supplementation as part of the autologous program is recommended. Where deemed appropriate, this should be commenced well in advance of the first collection because of the occurence of diarrhoea, while a less common side effect of oral iron than constipation, is an important contraindication to autologous collections in some areas.
A patient must be referred for autologous collection by the doctor primarily responsible for the procedure using a standard Australian Red Cross Blood Service request form. Please contact the local blood collection site for the appropriate documentation.
Requirements
- Autologous blood collections are only recommended where there is a reasonable expectation that blood will be required for the condition or procedure. Requests from medical practitioners should be related to the Maximum Blood Order Scedule (MBOS) as a guide regarding blood usage requirements during surgery.
- The indications for transfusion of autologous blood should be the same as for homologous blood. The NHMRC Clinical Practice Gudelines on Appropriate Use of Blood Components is a useful reference.
- Patient suitability for autologous collections is based on the ability to tolerate several venesections taken over a short period of time, age, adequate venous access, and reliable dates for elective surgery. In general, we will arrange blood collection between 5 and 35 days in advance of the anticipated date of surgery or transfusion. The final decision on acceptance of a patient into the program rests with the Australian Red Cross Blood Service.
- Autologous collections are made under the safety guidelines of the Australian Red Cross Blood Service. Collection of blood from patients who fall outside the safety standards set for autologous collections may only be carried out if appropriate medical cover is available.
- Autologous blood collections are subject to the same testing criteria as homologous collections within the Australian Red Cross Blood Service. All autologous blood is tested for hepatitis B, hepatitis C, HIV 1/2, HTLV I/II and syphilis. Should a test on a collection fail initial screeening, the patient and referring doctor will be notified and further collections suspended following the results of further testing. Collections confirmed as positive for a transfusion-transmisssible infection must be discarded and no further collections undertaken.
- In order to protect the safety of the homologous system, autologous blood which is not transfused into the patient cannot be used for any other patient.
- Autologous blood collection is generally subject to the same collection, storage and processing requirements as general homologous blood collection. The Australian Red Cross Blood Service reserves the right to manage autologous blood collection in the same manner as general homologous blood collection, including discarding the blood where necessary. In this event, both the patient and his/her practitioner will be advised.