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September 11, 1996

Preoperative Autologous Blood Donations Before Elective Hysterectomy

Author Affiliations

From Kaiser Permanente Medical Center, Woodland Hills, Calif (Drs Kanter and Anders, and Mss van Maanen and Clark); Kaiser Permanente Medical Center, Panorama City, Calif (Mr Castro and Dr Mya); and the Department of Pathology and Laboratory Medicine, University of California at Los Angeles (Drs Kanter and Anders).

JAMA. 1996;276(10):798-801. doi:10.1001/jama.1996.03540100042026

Objective.  —To determine whether preoperative autologous blood donation is justified for patients undergoing elective abdominal or vaginal hysterectomy.

Design.  —Retrospective cohort study.

Patients and Setting.  —A total of 263 consecutive patients admitted for elective abdominal or vaginal hysterectomy to a community health maintenance organization hospital during 1993 and 1994.

Main Outcome Measures.  —Evaluation of transfusion rates for patients who did and did not donate autologous blood; determination of any risk factors that would predict the need for transfusion; and evaluation of the need for transfusion based on chart review.

Results.  —Of 263 patients, 26 received a blood transfusion. The major risk factor identified for transfusion was the donation of autologous blood. Of 140 patients who donated autologous blood, 25 were transfused, whereas just 1 patient of 123 who did not donate autologous blood was transfused (P<.001). Patients who donated autologous blood had significantly lower mean admission hemoglobin level than patients who did not donate (119 g/L vs 132 g/L; P<.05); logistic regression showed that autologous donation was an independent risk factor for transfusion.

>Conclusion.  —For hysterectomy patients, donation of autologous blood causes anemia and is associated with a more liberal transfusion policy. These 2 factors result in a markedly increased incidence of transfusion with its associated risks. Elimination of preoperative autologous donation for these patients should not result in frequent exposure to allogeneic blood.