Should We Stop Collecting the Preoperative Autologous Blood before Bone Marrow Harvest?

Autor:	Pavel Jindra, Daniel Lysák, Lenka Hejretová, Marcela Hrabětová
Rok vydání:	2021
Předmět:	BONE MARROW HARVEST medicine.medical_specialty bone marrow Autologous blood Urology 030204 cardiovascular system & hematology Body weight Article Weight difference 03 medical and health sciences 0302 clinical medicine Blood loss medicine harvest Minimal risk business.industry allogeneic donor General Medicine CD34+ cells medicine.anatomical_structure preoperative autologous blood Medicine Bone marrow Hemoglobin business 030215 immunology
Zdroj:	Journal of Clinical Medicine Volume 10 Issue 10 Journal of Clinical Medicine, Vol 10, Iss 2134, p 2134 (2021)
ISSN:	2077-0383
Popis:	Preoperative autologous blood donation (PAD) in bone marrow (BM) donors is performed to meet potential post-harvest transfusion needs and to avoid the risk of allogeneic transfusions. We reviewed retrospectively bone marrow harvests in 216 healthy donors during a ten-year period to determine the use of autologous blood. All donors except four had undergone PAD. The initial hemoglobin level of 153 g/L (male donors) and 135 g/L (female donors), respectively, decreased by about 8 g/L after preoperative blood donation and by 23 g/L after bone marrow harvest (medians). Autologous blood was administered to 70% of donors, 30% of the units remained unused. The evaluation of the risk of reaching transfusion threshold (< 115 g/L males, < 105 g/L females) revealed that donors with initial hemoglobin above 145 g/L and those weighing above 75 kg have minimal risk of requiring blood substitution (about 10%). A larger volume of bone marrow was obtained from male compared to female donors (1300 vs. 1100 mL) because of their higher body weight, which resulted in a higher number of procured nucleated cells (362 vs. 307 × 106/kg TNC, ns). The donor-recipient weight difference predicted the probability of sufficient collection. Only 1.5% of donors weighing ≥ 20 kg more than recipients failed to reach ≥3 × 108/kg TNC recipient. Our findings affirm previous data that PAD is unnecessary for healthy marrow donors and may be indicated individually after considering the pre-collection hemoglobin level, donor and recipient weight, and expected blood loss. Reasonable substitution cut-offs have to be set together with clinical symptom evaluation. The effective use of PAD also requires an adequate time interval between PAD and BM harvest.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8ef3f26b38d2f8eb8d9e052cf300dac0 https://doi.org/10.3390/jcm10102134 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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