[Quality assurance in preoperative autologous blood collection from the viewpoint of the anesthetist].

Abstract

From the anesthetist's point of view the following safety measures regarding autologous blood donation have to be considered: [1] inclusion/exclusion criteria for the patient's selection; [2] quality control of the autologous product itself and [3] adequate technical standards of the equipment applied. There is no doubt, the criteria used for the patient's selection of an autologous predeposit program have a great impact both on the number and the severity of complications that might occur. Anesthetists consider a patient eligible for an autologous predeposit program if he/she is considered eligible for an elective operative procedure, too; since this means that this patient demonstrates compensated organ functions (e.g. of the cardiovascular system, of the pulmonary function as well as of the metabolic and hematopoietic system). As shown by data in the literature, these criteria even hold true in patients with serious (but compensated) concomitant diseases. In contrast to the routine procedure of homologous donation, monitoring of a patient during the autologous predeposit procedure as well as an adequate replacement of the volume of the autologous predeposit donated appear to be reasonable, especially in patients with serious risk factors. Following this concept, the number of undesired side effects during the autologous donation is in the same order as it is known from healthy volunteers for homologous donation. It appears wise to apply the same safety and quality standards for an autologous predeposit as for the comparable homologous products. Most important and without any restriction, the autologous product has to be safe for the patient: there should be no bacterial contamination of the autologous product, and the corpuscular content of the autologous plasma should not exceed a definite limit.(ABSTRACT TRUNCATED AT 250 WORDS)