An analysis of a preoperative pediatric autologous blood donation program.

OBJECTIVE: To determine the efficacy of a pediatric autologous blood donation program. DESIGN: A retrospective study of patient charts and blood-bank records. SETTING: The Children's Hospital of Eastern Ontario, Ottawa, a tertiary care, pediatric centre. PATIENTS: One hundred and seventy-three children who received blood transfusions for a total of 182 procedures between June 1987 and June 1997. INTERVENTIONS: Autologous and homologous blood transfusion required for major surgical intervention, primarily spinal fusion. MAIN OUTCOME MEASURES: Surgeons' accuracy in predicting the number of autologous blood units required for a given procedure, compliance rate (children's ability to donate the requested volume of blood), utilization rate of autologous units and rate of allogeneic transfusion. RESULTS: The surgeons' accuracy in predicting the number of autologous units required for a given procedure was 53.8%. The compliance rate of children to donate the requested amount of blood was 80.3%. In children below the standard age and weight criteria for blood donation the compliance rate was 75.5%. The utilization rate of autologous units obtained was 84.4% and the incidence of allogeneic transfusion was 26.6%. CONCLUSIONS: There was a high rate of compliance and utilization of predonated autologous blood in the children in the study. Preoperative blood donation programs are safe and effective in children, even in those below the standard age and weight criteria of 10 years and 40 kg.