Patients who predonate blood for autologous transfusion should have the last donation no later than 72 hours prior to surgery to allow re-establishment of intravascular volume. Further, the patient should not have an active infection or bacteremia at the time of donation. Certain medical conditions may be considered contraindications to preoperative autologous blood donation. Patients with severe aortic stenosis, unstable angina and severe left main coronary artery disease are often disqualified for autologous donation. Autologous transfusion is not without risk.
Clerical errors can occur.
Predonated blood can still be mislabeled and mistransfused. However, the indications for transfusion of autologous blood may be more liberal than for allogeneic blood due to elimination of transfusion-related risks to include infectious disease transmission and alloimmunization. Utilization of ANH may reduce the need for and the potential risks associated with allogeneic blood while providing a source of fresh whole autologous blood for transfusion. The primary compensatory mechanism to maintain oxygen delivery to the tissues with ANH is an increase in cardiac output. With the oxygen content of the blood supply to the myocardium reduced and an augmented cardiac output increasing myocardial oxygen consumption, the most significant potential complication from ANH is myocardial ischemia.