Australian Red Cross Blood Service

The routine use of preoperative autologous donation (PAD) is not recommended. From 1 July 2013, the Blood Service will no longer offer PAD collections except in patients with rare blood groups or complex antibodies.

PAD reduces the risk of allogeneic red cell transfusion but increases the risk of receiving any red cell transfusion (allogeneic and autologous).(1) Refer to Blood conservation for information on reasons why preoperative autologous donation is discouraged.

In the rare circumstances where PAD is indicated, the current Blood Service requirements and policy are applicable.

The referring doctor is responsible for:

• Providing information and gaining consent of the patient for the autologous collections. A patient information brochure is available to assist with this.
• Completion of the Blood Service Autologous Blood Request Form.

Patients must meet the Blood Service eligibility criteria for donors including a haemoglobin ≥120 g/L for females and ≥130 g/L for males. This will help minimise the risk of preoperative anaemia.

Not all State or Territory governments provide funding for autologous blood collection so a charge may apply for autologous collections in some areas.

We recommended that any autologous collection follow the Australian & New Zealand Society of Blood Transfusion (ANZSBT) Guidelines for Autologous Blood Collection.

Blood Service policy for autologous blood collections

1. From 1 July 2013 the Blood Service will no longer offer collections for PAD except in patients with rare blood groups or complex antibodies.
2. Currently, PAD is only recommended where there is a reasonable expectation that blood will be required for the condition or procedure. Checking the local Maximum Blood Order Schedule (MBOS) for estimated blood usage requirements during surgery will assist in decision making.
3. The indications for transfusion of autologous blood should be the same as for allogeneic blood.
4. Patient suitability for autologous collections is based on the ability to tolerate several venesections taken over a short period of time, age, adequate venous access, and reliable dates for elective surgery.
• The final decision on acceptance of the patient into the program rests with the Blood Service.
5. Autologous collections are made under the safety guidelines of the Blood Service.
6. Autologous blood collections are subject to the same testing criteria as allogeneic collections within the Blood Service.
• All autologous blood is tested for hepatitis B, hepatitis C, HIV 1/2, HTLV I/II and syphilis.
• Should a test on a collection fail initial screening, the patient and referring doctor will be notified and further collections suspended pending the results of further testing.
• Collections confirmed as positive for a transfusion-transmissible infection are discarded and no further collections undertaken.
7. In order to protect the safety of the allogeneic system, autologous blood which is not transfused to the patient cannot be used for any other patient.

Autologous blood collection is subject to the same collection, storage and processing requirements as allogeneic blood collection. The Blood Service reserves the right to manage autologous blood collection in the same manner as allogeneic blood collection, including discarding the blood where necessary. In this event, both the patient and their practitioner will be advised.

For assistance with appropriate documentation, please contact the Medical Services team in your state.

Reference

1. National Blood Authority. Patient Blood Management Guidelines: Module 2 – Perioperative. Australia, 2012.