Alternatives to homologous blood Transfusion

Alternatives to homologous blood Transfusion

(1) Autologous blood Transfusion:

Is: any bl. Component donated by intended recipient.

Benefits:     (low risk of):

                                              Alloimmunlzation

                              GVHD

                                              Infections dis. transmission.    

                                           Febrile, hlytic, allergic reaction.

Categories:

(1) autologus whole bl. Or KBcs.

* preoperative donation:

- before elective surgery (anticipated  bl. loss)

- contraindication:

                - symptomatic angina, AS, Valvular HD.

                - recent seizures.

                - hematocrit ↓ 33%

 * Intraoperative hemodilution:

- in cardiopulmonary bypass procedure.

-          1 or 2 units of bl. Removed →

-          replaced by colloid or crystalloid

-          → after surgery →

-          transf. of autol. b1ood& diuretics

-          (to ↓ plasma volume).

-          * post operative blood. salvage

-          Significant drainage form cavity as

-          chest cavity drainge ,,

-          collect blood during 24: 48 h postoerative →

-           Filteration →

-           reisfuse within 6h of collection

-          (2) Autologous plts transfusion.

-          Preoperative Collection by hemapharis

-          → frozen for future use

-          as anticipation of BM suppression during chemotherapy.

-          (3) autologous FFP or csuopercipitate.

-          Very uncommon indication.

-          (4) autologus concenterated fibrinogn.

-          Separated from autologus plasma.

-          (2) Growth factors

-          Epo: ↑ RBs production& ↓ need RBs donation

-          GM- CSF or G – csf:

-          stimulate hematopoiesis

-          used with BMT&chemotherapy.

-          (3) blood substitutes