Autologous blood banking, or pre-deposit autologous transfusion, is the process of collecting and storing a person’s own blood for future use, typically during an elective medical procedure. This practice is distinct from allogeneic donation, where blood is collected from one person for transfusion to any compatible recipient. Using one’s own banked blood eliminates the risks associated with transfusion, such as infectious disease transmission and immune reactions. The blood is labeled for the exclusive use of the donor, establishing a closed-loop system of self-donation.
When Autologous Blood Donation Is Necessary
Autologous blood donation is generally recommended for patients facing a planned, elective surgery where the likelihood of a blood transfusion is high. Common indications include major orthopedic procedures like total joint replacements, as well as complex vascular or cardiac surgeries where significant blood loss is anticipated. The decision to bank blood is made in consultation with a physician and is often considered only when there is at least a 50% chance the procedure will require a transfusion.
The practice is also particularly beneficial for individuals whose blood characteristics make finding a suitable match in the general supply difficult. This includes patients with very rare blood types or those who have developed multiple antibodies from previous transfusions or pregnancies. Using one’s own blood in these cases ensures complete compatibility and avoids the extensive searching required for rare allogeneic units.
Pre-deposit autologous donation is not appropriate for emergency procedures, as it requires several weeks of planning and collection time. It is also not universally encouraged for all surgeries, because modern allogeneic blood screening has made the community supply very safe, and donating blood preoperatively can sometimes induce mild anemia. Patients who donate their own blood may be more likely to receive a transfusion overall, which includes their autologous unit, compared to those who do not donate.
Donor Eligibility and Pre-Collection Requirements
The process begins with a physician’s written order, which acts as a prescription for the blood bank to collect and store the unit. Prospective donors must be in reasonably good health. Eligibility criteria for autologous donation are often less stringent than for allogeneic donation, primarily because the donor is not exposed to new infectious risks by receiving their own blood.
A specific minimum hemoglobin level, typically 11.0 grams per deciliter (g/dL), or a hematocrit of at least 33 percent, is required before each donation to ensure the procedure is safe for the patient. Iron supplements are frequently prescribed by the physician to help the body regenerate red blood cells between donations and prevent significant pre-surgical anemia. Donors must also meet general wellness criteria, such as having no active infection or fever on the day of donation.
Timing is a precise requirement, as the last donation must be completed a specific number of days before the scheduled procedure. This interval is usually at least 72 hours, but is often recommended to be a minimum of five working days. This allows the body to recover blood volume and permits the blood bank time for processing and testing. Donations are typically spaced one week apart, allowing a series of units to be collected in the weeks leading up to the surgery.
The Blood Collection and Preservation Procedure
The collection process involves drawing a standard unit of approximately one pint (around 450 milliliters) of whole blood. The session lasts about an hour, with the actual blood draw taking less than 10 minutes. The patient’s physician determines the number of units collected based on anticipated blood loss. Each unit is immediately labeled with the patient’s identification and designated for “Autologous Use Only.”
After collection, the blood is processed to separate it into components, such as packed red blood cells, which are the most commonly needed product during surgery. The short-term preservation method involves storing the red blood cells in a refrigerated solution at \(1^\circ\text{C}\) to \(6^\circ\text{C}\), which maintains their viability for up to 35 to 42 days. This liquid storage window is sufficient for most planned elective surgeries.
For situations requiring long-term banking, such as for individuals with extremely rare blood types or for procedures that may be delayed, a process called cryopreservation is used. This technique involves treating the red blood cells with a cryoprotectant, most commonly a high concentration of glycerol, before freezing them. The blood is then stored in specialized freezers at ultra-low temperatures, typically \(-80^\circ\text{C}\) or colder, which halts metabolic activity and allows the cells to remain viable for up to ten years or more.
Logistics of Storage and Retrieval
Autologous blood banking involves several distinct fees due to the specialized handling and coordination required. These costs typically include collection, processing, testing, and sometimes an annual storage fee if the blood is cryopreserved. Autologous collection is significantly more expensive than volunteer donations. Patients should confirm insurance coverage beforehand, as coverage for these extra costs can vary.
The storage duration for liquid-preserved autologous blood is limited to the 35- to 42-day expiration period set by the preservative solution. If surgery is postponed beyond this window, the units must be discarded or frozen for extended storage. Freezing is an additional expense and requires the blood to be thawed and washed before use, a process that is not immediately available.
For retrieval, the blood bank coordinates transportation of the labeled unit to the hospital where the surgery will take place. If collected externally, shipping and handling fees may apply, and transport must maintain the appropriate storage temperature. Autologous units that are collected but ultimately not transfused cannot be used for the general public. These unused units are discarded after their expiration date or the patient’s discharge.