术前1日自体贮血在择期心脏瓣膜手术患者中的应用

目的 评价术前1d自体贮血方案在择期心脏瓣膜手术中的应用效果.方法 选择2014年1～12月在北京安贞医院拟进行心脏瓣膜类择期手术的患者分为3组.A、B组为术前1d、术前3d进行自体贮血的患者,C组为术前未采集自体血的患者,每组91例.观察并比较3组患者围手术期用血情况、异体血输注量和住院天数.结果 A、B组异体血输血比例的差异无统计学意义(58.2％ vs.56.0％,P＞0.05),但A、B组的异体血输血比例均显著低于C组(96.7％,P＜0.05).A组输注悬浮红细胞0(0,2)U,血浆0(0,400)ml;B组输注悬浮红细胞0(0,2)U,血浆0(0,400)ml;C组输注悬浮红细胞2(0,4)U,血浆400(400,800)ml.A、B组红细胞和血浆用量显著低于C组,差异有统计学意义(P＜0.01).A、B、C3组中位住院天数分别为13(11,16)、15(13,19)、18(17,18)d,A组与B组,A组与C组分别比较,A组住院天数明显减少(P均＜ 0.05).结论 择期心脏瓣膜类手术患者术前1d实施自体贮血方案可以缓解血液短缺时期手术延期的问题,并可减少异体输血量,降低患者医疗负担,增加医院的病房床位周转率,具有推广价值.     

自体血液回输用于体外循环心脏手术的有效性、安全性及性价比

目的 评估自体血液回输用于体外循环(CPB)心脏手术的有效性、安全性和性价比.方法 将160例择期行CPB心脏手术的患者,随机分配到自体血液回输组(CS组)和对照组(C组),每组各80例.CS组,手术时非肝素化期间的所有创面及纵隔出血,经抗凝后全部吸入自体血液回输机.CPB结束后的管道剩余血,直接吸入自体血液回输机;C组,手术时非肝素化期间的所有创面及纵隔出血,CPB结束后的管道剩余血,均被丢弃.鱼精蛋白拮抗肝素后5 min至术后24h,若患者HB＜ 80 g/L,C组予异体RBC输注;CS组先输自体RBC,若在输完后HB仍＜ 80 g/L,予异体RBC输注.术后若出现异常出血,按流程处理.观察CS组术中自体血液回输量及2组围术期异体血液输注情况;观察围术期凝血功能损害及术后不良事件;观察输血相关费用.结果 CS组平均术中回输自体血液497.6 ml;围术期异体RBC输注比例和数量低于C组(P =0.0002,0.0001);手术结束时肝素残留发生率及术后异常出血发生率高于C组(P =0.035,0.039);异体红细胞费用及总异体输血费用低于C组(P=0.0001,0.0007);总输血费用高于C组(P=0.0001).结论 CS应用于心脏手术,可以降低围术期异体RBC输注比例和数量,不增加术后不良事件总发生率,但可在一定程度上损害凝血功能及增加总输血费用,因而是有效的、安全的和不具有性价比的.     

非体外循环冠状动脉旁路移植术患者术中输血的危险因素分析

目的:分析非体外循环冠状动脉旁路移植术(OPCABG)患者术中异体血输注的危险因素,为术前备血和围术期血液保护提供参考。方法:回顾性分析179例OPCABG患者临床资料,根据患者术中是否输注红细胞(血浆或血小板),将患者分为未输红细胞(血浆或血小板)组和输红细胞(血浆或血小板)组,分别研究患者术中输注红细胞(血浆或血小板)的危险因素。结果:179例OPCABG患者中,119例(66.5%)患者术中输注不同种类的血制品。多因素分析显示,影响红细胞输注的因素有术前血红蛋白水平、术中出血量和术中输注血浆;影响血浆输注的因素有手术时间、IABP置入、术中输注红细胞和术中输注血小板;影响血小板输注的因素有高血压和术中输注血浆。结论:OPCABG术中红细胞、血浆和血小板的输注受多种因素影响,术前充分评估患者临床资料,识别并适当干预危险因素,有助于科学合理备血和围术期血液保护。     

稀释式自体输血在心脏手术中的应用

目的 稀释式自身输血应用于心脏手术中观察不用或少用异体库血进行心脏手术效果.方法 对40例进行心脏手术患者(试验组)术中采用稀释式自身输血节血措施,同期使用异体输血法的40例心脏手术患者作为对照组,比较两组见血小板(plt) 血红蛋白(HB) 红细胞压积(HCT) 异体输血等差异.结果 稀释式能避免和减少输用异体血液,术后血小板血红蛋白和红细胞压积均无统计学行状差异(p>0.05).结论 心脏手术中采用稀释式自体输血能明显减少手术出血少输和不输异体血,降低对库血的需要量.     

自体输血对创伤性颅脑损伤患者凝血功能的影响

目的 观察术中回收式自体输血对创伤性颅脑损伤患者凝血功能的影响.方法 创伤性颅脑损伤行急诊开颅手术的患者199例,按是否使用自体输血分为自体血组108例和异体血组91例.观察两组患者手术出血量、输血量、输注含凝血成分血制品比例,以及入院时和出院时的凝血酶原时间(PT)、凝血酶原时间比值(PT-INR)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT).结果 自体血组输注含凝血成分血制品比例少于异体血组,术中输注异体红细胞、冷沉淀少于异体血组(P＜0.05).出院时两组患者PT、PT-INR、APTT、FIB、TT计数均明显高于入院时(P＜0.05),但两组间上述指标比较,差异均无统计学意义(P＞0.05).结论 自体输血不影响创伤性颅脑损伤手术患者的凝血功能.     

单采自体输血在外科手术中的临床应用研究

目的 探讨术前单采自体血液在外科手术中的临床应用.方法 选择ASA Ⅰ～Ⅱ级,估计术中出血量较大,符合国内外预存自体输血标准的外科择期手术患者8例,入院后第2、3天下午采用血细胞分离机单采,单采压积红细胞3～6U(来源于800 ～ 1200ml静脉全血的红细胞)和机采血小板1U,采集中补充生理盐水500 ～ 1000ml.当患者术中出血较多,患者收缩压下降至90mmHg以下时,开始回输自体血液,并于手术结束前全部回输入患者体内.观察8例患者预存采血前、单采后、手术前、手术结束后血常规[血红蛋白(Hb)、血细胞比容(Hct)、血小板计数(PLT)],手术结束时血压(SPB,DPB)、心率(HR)及手术中液体输入总量、术中出血量、自体输血量、异体输血、输血反应等情况.结果 8例患者术中输注自体血液,未输注异体血液成分,单采中和输血后均无明显不良反应.单采储血后和手术后的血红蛋白、血细胞比容、血小板计数明显低于自体储血前,手术失血量300 ～ 1200ml,占整体血容量的7％～ 26.49％.术后患者心率、血压平稳.结论 通过血细胞分离机单采血液成分进行自体备血安全且疗效较好,能保障中型及大型手术的手术用血.     

腹主动脉球囊阻断联合回收式自体输血在凶险型前置胎盘剖宫产术中的应用

目的探讨腹主动脉球囊阻断联合回收式自体输血在凶险型前置胎盘剖宫产术中的应用效果。方法选择行剖宫产术分娩的60例凶险型前置胎盘产妇,将在术前放置腹主动脉球囊,术中暂时阻断腹主动脉并回收式自体输血的30例患者作为观察组,按常规剖宫产操作的30例患者作为对照组(按指征输异体血)。比较两组出血与输血情况、手术前后血常规指标及围术期指标。结果观察组术中出血量、异体血浆输入量、异体红细胞悬液输入量及异体红细胞悬液输入率均低于对照组(均P<0.05),而两组产妇异体血浆输入率及术后24 h出血量比较,差异均无统计学意义(均P>0.05)。两组产妇术后8 h血小板计数、红细胞比容、红细胞计数及血红蛋白水平均低于术前(均P<0.05),但两组间上述指标差异均无统计学意义(均P>0.05)。观察组子宫切除率、产后出血发生率均低于对照组,抗生素使用时间短于对照组(均P<0.05),而两组产妇术后发热发生率、术后住院时间及新生儿体重比较,差异均无统计学意义(均P>0.05)。结论腹主动脉球囊阻断术联合回收式自体输血能明显减少凶险型前置胎盘产妇剖宫产术中出血量和抗生素使用时间...     

体外循环手术中自体输血的临床研究

目的通过将自体输血等多种节血措施综合应用于体外循环(extracorporeal circulation,ECC)心脏手术,观察不用或少用异体库血进行心脏手术的效果。方法对30例进行ECC心脏手术患者(实验组)术中采用综合节血措施,包括术前及ECC前采集自体血贮存术后回输、回输剩余机血、术前和术中应用药物保护血液提高凝血功能等。同期选择30例异体输血的心脏手术患者作为对照组,比较两组间血小板(Plt)、血红蛋白(Hb)、红细胞比积(Hct)、异体输血量及术后纵隔引流量等差异。结果实验组与对照组相比,术后Plt、Hb和Hct均无统计学显著性差异(P>0.05),而术后引流量、异体输血量实验组明显少于对照组(P<0.05)。结论心脏直视手术采用自体输血等多种综合节血措施,能明显减少手术出血,少输或不输异体血。     

血小板分离联合术中自体血回收对骨科大手术减少失血和血小板活化的影响

目的 探讨血小板分离联合术中自体血回收对骨科大手术节约用血和血小板活化的影响.方法 150例择期行骨科大手术的患者(估计术中出血量≥800ml),随机分为3组,每组50例.Ⅰ组进行自体血小板分离和术中自体血回收,术中分别予以回输;Ⅱ组只进行自体血回收,不进行血小板分离,术中予以回输;Ⅲ组为对照组,不进行上述任何血液保护措施,按需输注异体血.测定各组患者5个时间点的凝血酶原时间(PT)、部分凝血活酶时间(APTT)、血栓弹力图(TEG)的凝血功能参数[包括反应时间(R)、凝血时间(K)、a角、最大振幅(MA)和凝血指数(CI)]及血小板PAC-1、CD62P和CD63的表达量.结果术中Ⅰ、Ⅱ两组均未输注异体血,Ⅲ组输注异体红细胞悬液(2±1)U;术后Ⅰ组未输注异体血,Ⅱ组、Ⅲ组输注异体血比例分别为30%(15/50)和32%(16/50).3组间PT、APTT变化差异均无统计学意义(均P>0.05).Ⅰ组术后CD62P表达低于麻醉诱导前和输注自体富血小板血浆前(P<0.05).与Ⅰ组比较,术后Ⅱ组、Ⅲ组的MA值呈下降明显(P<0.05),而CD62P表达明显升高(P<0.05).3组间PAC-1、CD63表达差异均无统计学意义(均P>0.05).结论 术中自体血回收可以减少术中用血但不能减少术后出血和输血.血小板分离不会引起血小板活化,并在一定程度上保护血小板的功能,可以起到减少术后出血及节约用血的效果.     

自体富血小板血浆回输在迷宫Ⅲ型手术中的应用

目的探讨应用自体富血小板血浆回输技术对迷宫Ⅲ型手术的影响。方法回顾性分析2013年5月至2017年10月在本科接受迷宫Ⅲ型手术治疗瓣膜病合并心房颤动患者122例。根据是否应用自体富血小板血浆回输技术分为试验组(n=52)和对照组(n=70)。试验组体外循环开始前保存富血小板血浆,在鱼精蛋白中和肝素后再回输给患者。记录患者围术期资料及输血情况。结果试验组患者术后24 h引流量明显低于对照组(469±214)ml vs.(547±192)ml(P=0.037),试验组患者围术期输血比例明显少于对照组(30.8%vs.48.6%,P=0.049);两组患者在主动脉阻断时间、体外循环时间、呼吸机辅助时间、监护室停留时间及围术期并发症发生率差异无统计学意义(P0.05)。结论自体富血小板血浆回输可以减少迷宫Ⅲ型手术患者术后引流量,降低对同种异体血的输注需求,是一种较安全、有效的血液保护方法。     

自体血回输技术在心脏瓣膜置换术中的应用研究

目的探讨自体血回输在心脏瓣膜置换术中的应用价值。方法对43例择期行心脏瓣膜置换术患者采用京精自体血液回收机3000P型进行洗涤式自体血回输,并对患者术前和术后24小时血红蛋白（Hb）、红细胞比容（Hct）、红细胞计数（RBC）、白细胞计数（WBC）、血小板计数（PIt）、凝血活酶时间（Pr）、活化部分凝血酶时间（Am）、术后24小时引流量进行分析。结果43例患者所有的回收血经过血液回收机处理后共获得洗涤后浓缩红细胞为36400ml。手术前后患者RBC、APTT无明显变化（P〉0．05）,Hb、Hct低于术前（P〈0．05）,但也都位于正常参考值范围内,PIt比术前明显降低（P〈0．01）,WBC较术前明显增高（P〈0．01）,术后引流量均在可接受的范围内。所有患者在回输血过程中均无明显的不良输血反应。结论回收式自体血液回输可有效减少心脏瓣膜置换术中血液丢失,减少异体血输注量,减少输血费用,避免血液传播疾病及各种输血反应的发生。     

围手术期限制性红细胞输注的研究进展与指南对比

围手术期限制性输血策略认为异体红细胞输注的阈值可放宽至外周血血红蛋白浓度(Hb)<7~8 g/dl。限制性输血不仅有助于节约库存血,也可减少感染、免疫、容量负荷等方面的输血不良反应。从病生理角度,由于机体存在增加心输出量、调节血红蛋白与氧的结合率、扩张肺血管等代偿机制,故一定范围内Hb的下降未必导致缺氧。在接受髋关节手术、感染性休克和上消化道出血的患者中,限制性输血可使其获益;而在合并冠心病或接受心脏手术患者中,限制性输血可能与不良预后相关。多个学会发布的指南从不同角度推荐了限制性红细胞输注的适用范围,其中多将Hb<7 g/dl作为异体红细胞输注的指征之一,对Hb 7~10 g/dl者需依据预期出血量、患者代偿能力和代谢率具体分析。     

Transfusion practices among patients who did and did not predonate autologous blood before elective cardiac surgery

BACKGROUND: Preoperative autologous blood donation is commonly used to reduce exposure to allogeneic transfusions among patients undergoing elective cardiac surgery. However, this technique is associated with an overall increase in transfusions (allogeneic or autologous). The authors assessed the impact of transfusion decision-making on the effectiveness of preoperative autologous donation in reducing the frequency of allogeneic transfusions, and its impact on the increased transfusion rate associated with preoperative autologous donation in cardiac surgery. METHODS: This retrospective analysis compared transfusion practices among 176 patients who predonated autologous blood before elective cardiac surgery and 176 matched cardiac surgery patients who did not predonate blood. The impact of decision-making on transfusion exposure was determined using multivariate analyses to account for major perioperative interventions and complications. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for exposure to allogeneic blood transfusion or any transfusion, before and after exclusion of transfusions not conforming with selected transfusion criteria. RESULTS: Exposure to allogeneic transfusion was more likely among patients who did not predonate blood than among those who did predonate blood (OR 14.0, 95% CI 5.8-33.8). This finding was still true after exclusion of transfusions not meeting the transfusion criteria (OR 19.3, 95% CI 6.7-55.7). The autologous blood donors were more likely than the nondonors to receive any transfusion (OR 10.8, 95% CI 5.7-20.3). However, this association was substantially attenuated after exclusion of transfusions not meeting the transfusion criteria (OR 1.9, 95% CI 1.1-3.2). INTERPRETATION: Patients who predonated blood before elective cardiac surgery were at lower risk of receiving allogeneic transfusions than the nondonors. This was not because of a deliberate withholding of allogeneic transfusions from autologous donors. However, more liberal transfusion criteria for autologous blood were largely responsible for the increased transfusion rate among the autologous donors.     

Effect of Point-of-care Hemoglobin/Hematocrit Devices and Autologous Blood Salvage on Reduction of Perioperative Allogeneic Blood Transfusion

Objective To evaluate the effect of point-of-care hemoglobin/hematocrit (POC HGB/HCT) devices and intraoperative blood salvage on the amount of perioperative allogeneic blood transfusion and blood conservation in clinical practice. Methods A total of46 378medical records of 22 selected hospitals were reviewed. The volume of allogeneic red blood cell and plasma, number of patients transfused, number of intraoperative autologous blood salvage, total volume of autologous blood transfusion, and amount of surgeryin the year of 2011 and 2013 were tracked. Pairedt-test was used in intra-group comparison, whilet-test of two isolated samples carried out in inter-group comparison.P<0.05 was defined as statistically significant difference. Results In the hospitals where POC HGB/HCT device was used (n=9), the average allogeneic blood transfusion volume per 100 surgical cases in 2013 was significantly lower than that in 2011 (39.86±20.20vs. 30.49±17.50 Units,t=3.522,P=0.008). In the hospitals without POC HGB/HCT meter, the index was not significantly different between 2013 and 2011. The average allogeneic blood transfusion volume was significantly reduced in 2013 than in 2011 in the hospitals where intraoperative autologous blood salvage ratio [autologous transfusion volume/(autologous transfusion volume+allogeneic transfusion volume)] was increased (n=12,t=2.290,P=0.042). No significant difference of the above index was found in the hospitals whose autologous transfusion ratio did not grow. Conclusion Intraoperative usage of POC HGB/HCT devices and increasing autologous transfusion ratio could reduce perioperative allogeneic blood transfusion.     

自体血小板分离回输对体外循环心脏直视手术患者血液的保护作用

目的 评价自体血小板分离(autologous patelet-richplasma, aPRP)回输对体外循环心脏直视手术患者的血液保护作用。方法 选择体外循环心脏直视手术患者90例,将患者随机分为对照组(n=45)和自体血小板分离组(aPRP组,n=45)。aPRP组在麻醉诱导后行血小板分离,在肝素化之前完成富血小板血浆提取,于体外循环结束、鱼精蛋白中和肝素后回输,对照组不行血小板分离。于术前,术后1、24和48h记录Hb、Plt、PT、APTT及Fib,记录体外循环时间、主动脉阻断时间、术后引流量、输血情况。结果 aPRP组采集并回输富血小板血浆(323±117)ml,Plt分离时间(45±8)min。与对照组比较,aPRP组术后24h内引流量、输注异体血率下降(P＜0.05)。结论 自体血小板分离回输可改善体外循环心脏直视手术患者的凝血功能,降低术后出血量和异体血输注,具有血液保护作用。     

自体血液回输在腰椎手术中的应用

目的探讨自体血液回输在腰椎手术中的应用情况。方法应用国产自体2000型血液回输机对30例腰椎手术患者进行术中血液回输,同时对患者术前及术后进行血常规、血清电解质检查。结果通过血常规测定,红细胞回收率90%以上,全部病例术后恢复顺利,无输血反应及感染,血液回收效果良好。异体输血回避率100%,手术前后血清电解质无明显改变。结论腰椎手术中失血量较多,应用自体血液回输能有效减少自体血丢失和异体血输入,既节约血液,又可减少异体输血的不良后果。     

等容血液稀释自体输血对肿瘤患者围术期内环境和凝血功能的影响

目的观察和比较术中等容血液稀释自体输血和异体输血对肿瘤患者围术期机体内环境和凝血功能的影响。方法选择直肠癌、结肠癌和胃癌根治术患者40例,随机分为两组。A组术中输异体全血400mL;B组于手术切皮前放血400mL,同时输入等量羟乙基淀粉,术中自体血回输给患者。结果A组输血后1h及术后24hpH值和HC03一下降较B组明显（P〈0．05）;B组稀释后Hb明显低于A组（P〈O．05）;血常规其余各值、PT、APTT、FIB在各测定点两组变化一致,两组间均无显著差异（P〉0．05）。结论在一定范围内,等容血液稀释自体输血有利于维持肿瘤患者围术期内环境稳定,等容血液稀释自体输血与异体输血相比对凝血功能的影响差异不显著。     

腰椎间盘突出症手术中预存式自体输血的应用研究

目的探讨预存式自体输血在腰椎间盘突出手术中的效果。方法从本院腰椎间盘突出患者中选择60例术中输血患者的资料,其中30例患者采用预存式自体输血（观察组）,另外30例患者采用常规方式输血（对照组）,记录两组患者术中自体及异体输血量,检查两组患者术后血常规及输血相关不良反应,并进行统计比较。结果对照组患者异体输血（380±140）mL,5例患者出现皮疹、低热等不良反应,对症处理后好转;研究组自体输血（390±180）mL,1例出现心率减低,两组术中出血量比较,差异无统计学意义（P〉0.05）,两组不良反应比较,差异有统计学意义（P〈0.05）;两组输血3 d后白细胞较术前升高,血小板较术前降低,血红蛋白降低,治疗前后差异有统计学意义（P〈0.05）。两组术后3、7 d红细胞、血红蛋白、血小板比较,差异有统计学意义（P〈0.05）。结论腰椎间盘突出症手术中采用预存式自体输血可以避免异体输血,减少输血不良反应,且自体输血对患者血常规的影响较小,促进血常规更快恢复正常,值得应用。     

氨甲环酸减少体外循环心脏瓣膜置换术后出血的最佳使用时间

目的:观察体外循环心脏瓣膜手术中氨甲环酸的不同给药时间和术后早期出血?抗纤溶效果和血小板保护之间的关系?方法:45例心脏瓣膜病患者随机分为3组:TA-1组:体外循环中使用氨甲环酸1.0 g,其中0.5 g于体外循环开始后15 min快速滴入,另外0.5 g缓慢滴入维持至体外循环结束;TA-2组:体外循环结束使用鱼精蛋白中和肝素后使用氨甲环酸1.0 g静滴?对照组:体外循环中及结束后均不使用氨甲环酸?观察3组患者术后6?24 h的出血量?24 h红悬?血浆输入量,术后6 h D-二聚体及血小板计数?结果:TA-1组?TA-2组术后6?24 h出血量及红悬?血浆输入量较对照组均显著减少?TA-1组同TA-2组相比,术后6?24 h的出血量显著减少,而24 h血制品输入量较B组有减少趋势?3组间术后6 h的D-二聚体水平比较TA-1组< TA-2组<对照组,即TA-1组显著低于TA-2组和对照组,而TA-2组显著低于对照组?术后6 h血小板计数比较显示TA-1组明显高于TA-2?对照组,而后两组之间无显著性差异?结论:体外循环心脏瓣膜置换术中使用氨甲环酸较空白对照组可有效减少术后早期出血和血制品输入,体外循环中氨甲环酸持续静滴的止血?抗纤溶?血小板保护的效果要优于体外循环结束后单剂量给药的效果?     

Autologous versus allogeneic transfusion: patients'' perceptions and experiences

BACKGROUND: Preoperative autologous donation is one way to decrease a patient's exposure to allogeneic blood transfusion. This study was designed to determine patients' perceptions about the autologous blood donation process and their experiences with transfusion. METHODS: To assess patient perception, a questionnaire was administered a few days before surgery to patients undergoing elective cardiac and orthopedic surgery in a Canadian teaching hospital. All patients attending the preoperative autologous donation clinic during a 10-month period were eligible. A convenience sample of patients undergoing the same types of surgery who had not predonated blood were selected from preadmission clinics. Patient charts were reviewed retrospectively to assess actual transfusion practice in all cases. RESULTS: A total of 80 patients underwent cardiac surgery (40 autologous donors, 40 nondonors) and 73 underwent orthopedic surgery (38 autologous donors, 35 nondonors). Of the autologous donors, 75 (96%) attended all scheduled donation appointments, 73 (93%) said that they were "very likely" or "likely" to predonate again, and 75 (96%) said that they would recommend autologous donation to others. There was little difference in preoperative symptoms between the autologous donors and the nondonors, although the former were more likely than the latter to report that their overall health had remained the same during the month before surgery (30 [75%] v. 21 [52%] for the cardiac surgery patients and 30 [79%] v. 18 [51%] for the orthopedic surgery patients). When the autologous donors were asked what they felt their chances would have been of receiving at least one allogeneic blood transfusion had they not predonated, the median response was 80%. When they were asked what their chances were after predonating their own blood, the median response was 0%. The autologous donors were significantly less likely to receive allogeneic blood transfusions (6 [15%] for cardiac surgery and 3 [8%] for orthopedic surgery) than were the nondonors (14 [35%] for cardiac surgery and 16 [46%] for orthopaedic surgery). They were, however, more likely to receive any transfusion (autologous or allogeneic) than were the nondonors (25 [63%] v. 14 [35%] for cardiac surgery and 31 [81%] v. 16 [46%] for orthopedic surgery). INTERPRETATION: Patients who underwent preoperative autologous blood donation were positive about the experience and did not report more symptoms than patients who did not donate blood preoperatively. Autologous donors overestimated their chances of receiving allogeneic blood transfusions had they not predonated and underestimated their chances after they had predonated. They were less likely to receive allogeneic transfusions, but more likely to receive any type of transfusion, than were patients who did not predonate.