Autologous Blood Transfusion in Cardiovascular Surgery

Fifty‐one patients admitted to the Cardiovascular Service of the University of Puerto Rico Hospital underwent a variety of cardiovascular operations utilizing autologous blood. Single or multiple phlebotomies were performed prior to surgery; the usual volume withdrawn was 500 ml. All patients received hydrogenated dextran complex intramuscularly. Fifty operations were performed. Thirty patients underwent a single phlebotomy, 15 patients two phlebotomies, three patients three phlebotomies and one patient underwent four phlebotomies. Thirty of the 50 operations were thoracotomies, 15 were done with autologous blood only. During actual surgical procedures 93.8 units of blood were used of which 56.5 units were autologous (60%) and 37.3 homologous. All patients except one had hematocrit values above 35% before the first phlebotomy. The reticulocyte count increased to two or three per cent, but it never exceeded five per cent. The advantages obtained with the use of auto‐transfusion are: 1) the prevention of transfusion reactions; 2) the prevention of serum hepatitis and other infections; 3) the availability of rare blood; 4) early reticulocytes and accelerated erythropoiesis.