Supplemental findings of the 2019 National Blood Collection and Utilization Survey.

INTRODUCTION: Supplemental data from the 2019 National Blood Collection and Utilization Survey (NBCUS) are presented and include findings on donor characteristics, autologous and directed donations and transfusions, platelets (PLTs), plasma and granulocyte transfusions, pediatric transfusions, transfusion-associated adverse events, cost of blood units, hospital policies and practices, and implementation of blood safety measures, including pathogen reduction technology (PRT). METHODS: National estimates were produced using weighting and imputation methods for a number of donors, donations, donor deferrals, autologous and directed donations and transfusions, PLT and plasma collections and transfusions, a number of crossmatch procedures, a number of units irradiated and leukoreduced, pediatric transfusions, and transfusion-associated adverse events. RESULTS: Between 2017 and 2019, there was a slight decrease in successful donations by 1.1%. Donations by persons aged 16-18 decreased by 10.1% while donations among donors >65 years increased by 10.5%. From 2017 to 2019, the median price paid for blood components by hospitals for leukoreduced red blood cell units, leukoreduced apheresis PLT units, and for fresh frozen plasma units continued to decrease. The rate of life-threatening transfusion-related adverse reactions continued to decrease. Most whole blood/red blood cell units (97%) and PLT units (97%) were leukoreduced. CONCLUSION: Blood donations decreased between 2017 and 2019. Donations from younger donors continued to decline while donations among older donors have steadily increased. Prices paid for blood products by hospitals decreased. Implementation of PRT among blood centers and hospitals is slowly expanding.

Multidisciplinary In Situ Simulation-Based Training as a Postpartum Hemorrhage Quality Improvement Project.

BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements. Our objective was to assess participant comfort with managing obstetric hemorrhage following our multidisciplinary in situ simulation training exercise. METHODS: This was a quality improvement project that utilized a comprehensive multidisciplinary in situ postpartum hemorrhage simulation exercise. Participants from the Departments of Obstetrics and Gynecology, Anesthesia, Nursing, Pediatrics, and Transfusion Services completed the training exercise in 16 scenarios run over 2 days. The intervention was a high fidelity, multidisciplinary in situ simulation training to evaluate hospital protocols, team performance, operational readiness, and system improvements. Structured debriefing was conducted with the participants to discuss communication and team functioning. Our main outcome measure was participant self-reported comfort levels for managing postpartum hemorrhage before and after simulation training. A 5-point Likert scale (1 being very uncomfortable and 5 being very comfortable) was used to measure participant comfort. A paired t test was used to assess differences in participant responses before and after the simulation exercise. We also measured the time to prepare simulated blood products and followed the number of postpartum hemorrhage cases before and after the simulation exercise. RESULTS: We trained 113 health care professionals including obstetricians, midwives, residents, anesthesiologists, nurse anesthetists, nurses, and medical assistants. Participants reported a higher comfort level in managing obstetric emergencies and postpartum hemorrhage after simulation training compared to before training. For managing hypertensive emergencies, the post-training mean score was 4.14 compared to a pretraining mean score of 3.88 (p = 0.01, 95% confidence interval [CI] = 0.06-0.47). For shoulder dystocia, the post-training mean score was 4.29 compared to a pretraining mean score of 3.66 (p = 0.001, 95% CI = 0.41-0.88). For postpartum hemorrhage, the post-training mean score was 4.35 compared to pretraining mean score of 3.86 (p = 0.001, 95% CI = 0.36-0.63). We also observed a decrease in the time to prepare simulated blood products over the course of the simulation, and a decreasing trend of postpartum hemorrhage cases, which continued after initiating the postpartum hemorrhage simulation exercise. DISCUSSION: Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality in the United States. Comprehensive hemorrhage protocols have been shown to improve outcomes related to postpartum hemorrhage, and a critical component in these processes include communication, teamwork, and team-based practice/simulation. As medicine becomes increasingly complex, the ability to practice in a safe setting is ever more critical, especially for low-volume, high-stakes events such as postpartum hemorrhage. These events require well-functioning teams and systems coupled with rapid assessment and appropriate clinical action to ensure best patient outcomes. We have shown that a multidisciplinary in situ simulation exercise improves self-reported comfort with managing obstetric emergencies, and is a safe and effective way to practice skills and improve systems processes in the health care setting.

Potential impact on blood availability and donor iron status of changes to donor hemoglobin cutoff and interdonation intervals.

BACKGROUND: A minimum male hemoglobin (Hb) level of 13.0 g/dL becomes a Food and Drug Administration requirement effective May 2016. In addition, extending whole blood (WB) interdonation intervals (IDIs) beyond 8 weeks has been considered to reduce iron depletion in repeat blood donors. This study estimates the impact these changes might have on blood availability and donor iron status. STUDY DESIGN AND METHODS: Six blood centers participating in Retrovirus Epidemiology Donor Study-II (REDS-II) collected information on all donation visits from 2006 to 2009. Simulations were developed from these data using a multistage approach that first sought to adequately reproduce the patterns of donor return, Hb and ferritin levels, and outcomes of a donor's visit (successful single- or double-red blood cell donation, deferral for low Hb) observed in REDS-II data sets. Modified simulations were used to predict the potential impact on the blood supply and donor iron status under different Hb cutoff and IDI qualification criteria. RESULTS: More than 10% of WB donations might require replacement under many simulated scenarios. Longer IDIs would reduce the proportion of donors with iron depletion, but 80% of these donors may remain iron-depleted if minimal IDIs increased to 12 or 16 weeks. CONCLUSION: Higher Hb cutoffs and longer IDIs are predicted to have a potentially large impact on collections but only a modest impact on donor iron depletion. Efforts to address iron depletion should be targeted to at-risk donors, such as iron supplementation programs for frequent donors, and policy makers should try to avoid broadly restrictive donation requirements that could substantially reduce blood availability.

[Implementation of blood sparing programs in Spain: results of a survey of departments of anesthesiology and resuscitation]. / Implementación de los programas de ahorro de sangre en España: resultados de la encuesta a los servicios de anestesiología y reanimación.

The objective of this article is to determine the availability of a perioperative transfusion management program (Patient Blood Management [PBM]) in various hospitals through a survey that included a description of the preanesthesia visit, the availability and use of the various blood-sparing techniques and the factors limiting their implementation in elective surgery. The survey included 42 questions, directed at the representative departments of anesthesiology of hospitals in Spain (n=91). The survey was conducted from September to November 2012. We analyzed the 82 surveys in which all the questions were answered (90%). Preoperative consultations are routinely performed (>70%) in 87% of the hospitals. The time from the consultation to surgery varied between 1 week and 2 months for 74% of the patients scheduled for orthopedic or trauma surgery, 78% of those scheduled for oncologic surgery and 77% of those scheduled for cardiac surgery. Almost all hospitals (77, 94%) had a transfusion committee, and 90% of them had an anesthesiologist on the committee. Seventy-nine percent of the hospitals had a blood-sparing program, and the most widely used technique was the use of antifibrinolytic agents (75% of hospitals), followed by intraoperative and postoperative blood recovery in equal proportions (67%). Optimization of preoperative hemoglobin was routinely performed with intravenous iron in 39% of the hospitals and with recombinant erythropoietin in 28% of the hospitals. The absence of a well-established circuit and the lack of involvement and collaboration with the surgical team were the main limiting factors in implementing PBM. Currently, the implementation of PBM in Spain could be considered acceptable, but it could also be improved, especially in the treatment of preoperative anemia. The implementation of PBM requires multidisciplinary collaboration among all personnel responsible for perioperative care, including the health authorities.

Evaluation of blood donor deferral causes in the Trinidad and Tobago National Blood Transfusion Service.

The majority of blood donations in Trinidad and Tobago are made as replacement by family members or friends. National Blood Transfusion Policy was drafted in 2007 to promote voluntary, repeated donation. The objective of this study is to assess the current rate and reasons for donor deferral, and the aim is to guide the proposed donor education and recruitment programme. A retrospective study of pre-donation deferral of prospective blood donors at the National Blood Transfusion Centre, Port of Spain, Trinidad and Tobago, was conducted. Records of all pre-donation deferrals over a 12-month period were studied. As many as 11,346 pre-donation screening interviews were conducted. There were 4043 (35.6%) deferrals. The most common reasons for donor deferral were exposure to high-risk sexual activity (27.6%), low haemoglobin 22.2% and hypertension 17.5%. Other reasons such as medication, chronic medical illness, tattoos, travel history, recent pregnancy, surgery or presentation outside the accepted age limit caused 33.8% of all deferrals and the majority (34.7%) of male deferrals. Low haemoglobin (44.5%) was the most common reason among females. The rate of deferral of voluntary donors was not significantly different from that for replacement donors (31.7 vs. 35.4%, P = 0.25). This study exposed a lack of public awareness as the principal reason for an unacceptably high rate of donor deferral. Donor education about selection criteria needs to be urgently addressed as an objective of the National Policy. Monitoring and evaluation of deferral rates and reasons could be used as one indicator of the effectiveness of the Policy.

Results of a general hepatitis C lookback program for persons who received blood transfusions in a neonatal intensive care unit between January 1975 and July 1992.

OBJECTIVE: To notify persons who received a blood transfusion in a neonatal intensive care unit between January 1975 and July 1992 of their risk for hepatitis C infection and to encourage them to seek hepatitis C antibody testing. DESIGN: Neonatal intensive care unit, blood bank, and public access records were queried to identify current mailing addresses and persons deceased. All persons were notified by letter. SETTING: Anchorage, Alaska. PARTICIPANTS: Persons who received health care in an integrated health care system, the Alaska Native Medical Center, or in the private sector. Main Exposure Transfusion in the neonatal period. MAIN OUTCOME MEASURES: Prevalence of test results positive for the hepatitis C virus antibody and RNA and awareness of having received a blood transfusion in a neonatal intensive care unit. RESULTS: Alaska Native Medical Center (n = 401) and private sector (n = 1396) persons were targeted for notification. Letters were mailed to 277 Alaska Native Medical Center (69%) and 374 private sector (27%) persons, with 151 (55%) and 65 (17%) screened for hepatitis C, respectively. Among those screened (n = 216), 7 (3%) were hepatitis C antibody positive, with 6 (<3%) also hepatitis C virus-RNA positive. Among 147 persons who responded, 75 (51%) were unaware they had received a transfusion. CONCLUSIONS: Compared with the private sector, a higher proportion of persons were identified and tested from the integrated health care system and more than half of respondents were unaware of their transfusion history. It would be prudent to screen neonatal intensive care unit patients who received transfusions before July 1992 for hepatitis C virus infection.

Seroprevalencia de anticuerpos anti-Brucella en disponentes de sangre con fines terapéuticos en tres bancos de sangre del Instituto Mexicano del Seguro Social / Anti-Brucella Antibody Seroprevalence in Blood Donors for Therapeutic Ends at Three Blood Banks of the Mexican Institute of Social Security

Introducción: la brucelosis es una zoonosis, que causa grandes pérdidas económicas en las zonas conurbanas de la Ciudad de México y es un problema importante de salud pública en los habitantes circunvecinos al Distrito Federal. El objetivo fue detectar anticuerpos anti-Brucella y según los resultados que proporcionó esta investigación, se propone como prueba de laboratorio de escrutinio en los donadores de sangre. Material y métodos: se analizaron 500 sueros sanguíneos de disponentes efectivos seleccionados y cuya muestra fue representativa de acuerdo al análisis estadístico elaborado. Las pruebas de laboratorio incluyeron Rosa de Bengala, Aglutinación Estándar en Microplaca y 2 Mercaptoetanol. Resultados: de los 500 sueros analizados 18 mostraron seropositividad con una tasa de seroprevalencia de 3.6%, predominando el sexo masculino (83.4%), por grupo de actividad las secundarias (72.2%), por grado de estudios académicos los de secundaria fueron los de mayor positividad (55.6%). Conclusión: la brucelosis posee características epidemiológicas peculiares en los bancos de sangre participantes en esta investigación, por lo que es importante incluir pruebas de escrutinio en búsqueda de anticuerpos anti-Brucella en los disponentes de sangre efectivos.

Introduction: to determine seroprevalence for Brucella sp. in blood donors, a serologic study was carried out at three blood banks of the Instituto Mexicano del Seguro Social (IMSS). Methods: 500 blood samples were taken from selected blood donors. Laboratory tests were used, such as Bengal rose (BR), Standard agglutination in microplate (SAM) and in presence of 2-Mercaptoethanol agglutination in microplate (2ME), which were applied to 500 blood sera from selected effective blood donors. The sample was representative according to the statistical analysis developed. Results: 18 of 500 analyzed sera were positive, with seroprevalence of 3.6%, male sex (83.4%), predominating, as secondary activity group (72.2%). According to academic archivement, blood donors with secondary school had highest seropositivity (55.6%). Conclusion: In this study, we conclude that brucellosis has peculiar epidemiologic characteristics in blood banks that participated in this research; therefore it is highly recommended to perform screening tests such as BR, SAM, and 2ME to identified anti-Brucella antibodies in the sera of effective blood donors.

Use of red blood cell transfusions in surgery.

BACKGROUND: Limited blood supplies necessitate the rational use of blood products. The aim of the present study was to provide a basis for audits of red cell usage in surgery by benchmarking common practice. Application of the data to the construction of a maximum surgical blood order schedule may be relevant for centres that perform a serological crossmatch or who collect autologous units. METHODS: Data on surgical procedures identified by Commonwealth Medical Benefits Schedule item numbers, were collected retrospectively from theatre and blood bank records at the Royal Melbourne and Melbourne Private hospitals from May 1997 to April 1998. The percentage of procedures for which red cells were transfused, and the mean, median and range of units transfused for procedures with >/= 30% transfusion likelihood were identified. RESULTS: Over 12 months, 266 surgical procedure codes were itemized >/= 10 times each, contributing 12 300 data entries. Only 38 procedures demonstrated an incidence of transfusion of at least 30%. Most frequently transfused procedures included spinal fusion, total hip replacement, mandible/maxilla resection, prostatectomy and bladder excision. CONCLUSION: The number of common surgical procedures in which there is a 30% or greater likelihood that red cell transfusions will be given is limited. This benchmarking of common red cell usage is a first step in the process of determination of transfusion appropriateness.

Autologous blood donation and transfusion in Europe.

BACKGROUND AND OBJECTIVES: The aim of this study was to record practices in autologous blood transfusion in Europe in 1997. MATERIALS AND METHODS: A questionnaire mainly about predeposit was distributed to the National Representatives of all 41 member states of the Council of Europe's Committee of Experts on Blood Transfusion and Haematology. Replies were received from 29. RESULTS AND CONCLUSION: Autologous blood units collected in 1997 amounted to 4.2% of the allogeneic units, with wide variations between countries. Predeposit was used most frequently in Italy (8.9%), Germany (7.1%) and France (6.6%). Some countries, notably Scandinavia, do not encourage predeposit, chiefly on the grounds that it is not cost-effective, but others are promoting its use.

[Prospective study of the causes for destruction of labile blood products during 1999 at a University Hospital Center]. / Etude prospective des causes de destruction des produits sanguins labiles, au cours de l'année 1999 dans un CHU.

The destruction of the blood cell product (BCP) is a situation which is hard to accept in the present context of transfusional safety which aims at covering the transfusional needs in the most appropriate way. In our University Hospital, 500 BCP out of 20,000 are destroyed per year, which represent a cost of 100,000 $. A prospective research was carried out from January 1st to December 31st 1999 in order to analyse the causes of the destruction of the BCP and to differentiate the inevitable destructions for the patient's security from the avoidable destructions which might have benefited from corrective measures. For each group of simultaneously destroyed BCP, an information note specified the patient's pathology, the reasons for the prescription, the number and the type of transfused and destroyed BCP in the same day, the time spent between distribution and return, and the causes of destruction. In 1999, a total of 483 LBP out of 19,802 which were distributed, have been returned and destroyed, that is to say 2.4% for a 99.3% traceability which involved 242 patients. Among these destroyed BCP, 28.3% came from inevitable causes--death or acute intensive care which needed a lot of transfusions--69.7% were categorised as being related to avoidable causes depending on the organisation of transport and care, unadapted safety measures. The corrective measures to be taken, concern the improvement of transport procedures, the set-up of a nominative BCP reservation system in the Blood Center, the scheduling of the BCP deliveries from the blood bank, and a better adaptation of the safety measures to the transfusional needs.

Should the cell saver autotransfusion system be routinely used in elective aortic surgery?

The objective of this study is to identify the aortic surgery procedures in which the use of the Cell Saver autotransfusion system is beneficial in terms of the amount of autologous blood recovered and the reduction in blood bank demands. An evaluation of the cost-effectiveness of the system is also presented. Four hundred and thirty-four elective aortic interventions were retrospectively reviewed to examine the use of intraoperative autotransfusion (IAT). Evaluation was made of risk factors, preoperative hematological variables, the volume of IAT-processed reinfused blood, and homologous transfusion requirements over the period of hospitalization. The routine use of the IAT system was cost-effective in the interventions for AAA and TAA. In patients subjected to aortobifemoral bypass for aortoiliac occlusive disease, IAT served to alleviate demands on blood bank inventories, although in our center its use led to a slight increase in net cost. The routine use of IAT during unilateral revascularization due to occlusive disease offered no benefits in terms of reduced homologous transfusion requirements or cost-effectiveness.

[Transfusion and pre-deposit autotransfusion in orthopedic and traumatologic surgery]. / Transfusión y autotransfusión predepósito en cirugía ortopédica y traumatológica.

PURPOSE: We present a retrospective study about the transfusional needs and the results of the preoperative autologous donation programme in our centre during 1996, in the Orthopaedic and Traumatologic Surgery Service's patients (SOT). PATIENTS AND METHODS: During 1996 the SOT Service carried out 592 major programmed surgical procedures with implants: hip prostheses (HP), knee prostheses (KP) and spinal column fixings (SCF). We've reviewed transfusion forms of the Blood Bank and the preoperative autologous donation forms of the patients sent to us. We've analysed the data with the EpiInfo 6.04 of CDC. Atlanta and SSPS programmes, using the chi 2 of Pearson's Test for qualitative variables and T-Student's test for 2 quantitative variables. RESULTS: The put 387 HP, 118 KP and 87 SCF. 1399 units of blood were administered to 437 patients: 310 HP, 64 KP and 63 SCF. The units/patient (U/P) mean was: 3.3 in HP, 2.3 in PTR and 3.5 in SCF. They sent 99 patients to be programmed for autotransfusion, of which 15 were excluded. The patients' number and the surgical procedures were: 39 HP, 7 KP and 38 SCF. They solicited 247 units (2.9 U/P) and we took out 91.4% of these and the programme was finished in the 73.8% of patients. They transfused 311 U, autologous 176, to 91.6% of programmed patients. Only autologous blood was received by 48% of transfused patients without any statistically significant differences (SSD) (p > 0.05) between the different prostheses. The difference among the transfusion needs of HP and SCF and over KP is SSD (p < 0.001), being non significant between HP and SCF. The probability of getting an autotransfusion programme is bigger in SCF, with a SSD (p < 0.001) of SCF over the HP and the KP and non significant between the last two. The probability of being transfused is greater in the programmed autotransfusion group, this being SSD (p < 0.001), as much of global form as comparing separately each type of prostheses. In the programmed autotranfusion group there are no SSD (p > 0.05) between the type of prostheses and the probability of being transfused, finding the same SSD when we compare the U/P mean and each type of prostheses. The opposite occurred to the patients programmed, it is SSD (p < 0.001) as much of global form as comparing the U/P means in each type of prostheses. Finally, between the global U/P transfused global in the patients that we did an autotransfusion on and those we didn't the difference is SSD (p < 0.001), seeing the same SSD comparing the U/P means in each type of prostheses between both groups. CONCLUSIONS: Given that the autotransfusion is safer than the homologous transfusion and the high percentage of this type of patients that need transfusion, 80% of HP, 54% of KP and 73% of SCF 72%, it would be desirable to enlarge the autotransfusion preoperative programme because it is only carried out on 14.18% of this type of procedures.

[Need for a pre-deposit autotransfusion program for patients undergoing elective surgery]. / Necesidad de un programa de autotransfusión con predepósito en pacientes sometidos a cirugía programada.

INTRODUCTION: Preoperative autologous hemodonation is a very useful procedure, but it is not exempt from risks. To reduce them we must ascertain the frequency of autologous donation and the amount of blood needed for each intervention. The objective of this work is to know which are the subsidiary interventions of autotransfusion, which are true necessities of blood for them. PATIENTS AND METHODS: All the crossmatched blood units preserved for surgical procedures that might be allocated for autotransfusion were controlled. The source service, the type of intervention, and the number of units requested and transfused were identified. RESULTS: 269 surgical interventions were controlled. For these interventions, 666 units of blood were reserved. No blood transfusion was necessary in 69% of the surgical operations. The number of units transfused was 229 (26.28%). Traumatology and Heart Surgery were the services that demanded more blood. The procedure with greatest requirements of blood units was the total knee replacement. Hysterectomy was the intervention with the lowest percentage of utilization of reserved blood (5.26%). CONCLUSIONS: Autotransfusion should be offered to all patient in need of knee or hip replacement and those who are subjected to heart surgery with extracorporeal circulation. Patients who are programmed for interventions with a low percentage of utilization of blood, should know these findings, in order that they don't feel subjected to unnecessary procedures.

Red blood cell transfusion practices in patients undergoing orthopedic surgery: a multi-institutional analysis.

This retrospective review analyzed and compared transfusion practices in patients undergoing orthopedic surgery in five Massachusetts hospitals with current practice guidelines; opportunities for improvement were identified. Patient-specific clinical information and data about transfusion practices were obtained from the medical records of 384 Medicare patients undergoing orthopedic surgery between January 1992 and December 1993. The number of patients who donated autologous blood preoperatively differed significantly among hospitals as did the number of autologous units that were unused. The number of blood units transfused at each transfusion event also differed significantly; some surgeons transfused > or =2 units in the majority of their patients, while others transfused 1 unit at a time. This variation in practice was not explained by differences in patients' clinical status. The mean pretransfusion hematocrit was higher for autologous versus allogeneic blood, suggesting more liberal criteria to transfuse autologous blood. Nearly half of all transfusion events were determined to have been potentially avoidable. Avoidable transfusions were also three to seven times more likely with autologous than with allogeneic blood. Significant inter-hospital differences existed in the number of elective surgery patients exposed to allogeneic blood. The major determinant of allogeneic blood use in these patients was the availability of autologous blood. Each additional autologous blood unit available decreased the odds of allogeneic blood exposure twofold. Differences in intraoperative and postoperative blood salvage use also were noted. These findings indicate that significant variations in practice exist. Comparative data enabled hospitals to identify and target specific areas for improvement.

Situaciòn de la transfusiòn de sangre inocua en el Paraguay durante el periodo 1990-1994 / Annual reports 1996 / Situation of the tranfusion of inocue blood in Paraguay during the period of 1990-1994

La transmisiòn de enfermedades infecciosas por vìa transfusional ha adquirido cada vez màs importancia debido a la gran migraciòn de contingentes poblacionales de paìses endèmicos a otros no endèmicos, agravada por la falta de control serològico en los bancos de sangre. Con el propòsito de aportar mayor informaciòn sobre la mayorìa de bancos de sangre en el Paraguay el presente trabajo revisa la informaciòn pre-existente sobre seroprevalencia de las enfermedades serocontroladas en bancos pùblicos y privados. Ademàs, realiza una descripciòn de datos actualizados sobre la administraciòn de sangre inocua en el Paraguay

Estudio clínico y epidemiológico en donantes de sangre seropositivos por trypanosoma cruzi / Clinical and epidemiological study of blood donors seropositive for Chagas disease

One hundred eleven seropositive donors, detected between 1994 and 1996, were studied. Serological reactions were confirmed with ELISA and indirect immunofluorescence reactions. Those confirmed as positive were subjected to a clinical-epidemiological questionnaire, physical examination, EKG and barium enema or swallow according to symptoms. Results: Seventy individuals were confirmed as positive for Chagas disease. Most of them lived at least once in an endemic zone for Chagas positive for Chagas disease. Most of them lived at least once in an endemic zone for Chagas disease or in a sun-dried clay brick house. Forty percent of individuals knew reduviid bugs and 14 pecent had been bitten by these insects. Twenty six percent of these subjects had an abnormal EKG (6 percent with bradicardia). No digestive diseases attributable to Chagas disease were detected. Conclusions: The high prevalence of problems attributable to Chagas disease among seropositive blood donors underscores the need of an epidermiological follow up of these individuals

Uso de la transfusion autologa en receptores de sangre de Cirugia programada, Hospital San Juan de Dios. Santa Cruz, Bolivia. 1996-1997 / Use antologous transfusion in recipients of blood at programmed surgery, Hospital San Juan de Dios, Santa Cruz-Bolivia 1996-1997

La transfusion de sangre autologa es un procedemiento recomendado en cirugia programada. En el Hospital San Juan de Dios, en 120 cirugias menos del 1 por ciento de los receptores. El 59 (48 por ciento de los receptores con indicacion de transfusion de sangre tenian un nivel de hemoglobina de 12,5 por ciento o mas, en los cuales puedo haberse indicado esta modalidad de transfusion, lo que nos permite recomendar el uso mas frecuentes de ella. Se transfundio a 44 pacientes durante la cirugia. Solo 7 de ellos (16 por ciento) perdieron 500 ml de sangre o mas, lo que significa que se esta indicando en formas injustificada una proporcion significativa de transfusiones de sangre lo que nos permite recomendar la reactualizacion de la clase medica en la indicacion de la transfusion