Pre-deposit autologous blood donation as a tool for reducing risks associated with allogeneic blood transfusion in Nigeria: is it worth nurturing?

Abstract

Background: Pre-deposit autologous blood donation (PAD) wherein patient's own blood is collected over a period of time in the lead up to a planned transfusion to the same patient may be a viable alternative to reducing the known and unknown risks often associated with allogeneic blood.

Objectives: To assess the practice of pre-deposit autologous blood donation at a hospital-based blood bank unit in north central Nigeria over a four year period.

Materials and method: This cross sectional study retrospectively assessed blood transfusion documents and records at the blood bank unit of Federal Medical Centre, Makurdi from 2009 to 2012. Information on predeposit autologous and allogeneic blood donations, types of blood donors and components or products utilized from the records and documents were analysed for proportions using Microsoft Excel and manual methods.

Results: Pre-deposit autologous blood donation was generally low ( average 0.40%) and showed a gradual decline over the years; 0.79, 0.31, 0.27 and 0.21 percent in comparison with allogeneic blood donation (76.71, 78.21, 84.76 and 80.36%) average 80.02% and 22.50, 21.49, 14.95 and 19.44 average 19.60% for family replacement and VNRBDs respectively in the years 2009, 2010, 2011 and 2012 respectively. Whole blood and packed red cells transfusions were the predominant blood products utilized over the years with 96.64, 99.04, 97.83 and 98.18% (average 98.32) transfusedas whole blood while 2.57, 0.65, 1.90 and 1.61% (average 1.68%) was transfused as packed cells respectively. All the pre-deposit autologous donations and over 95% of all allogeneic blood donations were transfused as whole blood over the study period.

Conclusion: Pre-deposit autologous blood donation is hardly practiced in a setting of high risk and unsafe allogeneic blood due to inadequate implementation of practice guidelines by practitioners.

Recommendation: Further researches are needed to improve the overall safety of pre-deposit autologous blood donation especially in a weakened centrally controlled blood system existent in Nigeria. It may be pertinent to provide adequate knowledge, reassess and develop existing guidelines for the practice of PAD in Nigeria.

Keywords: Pre-deposit autologous donation; allogeneic blood donation; hospital blood bank; northcentral Nigeria