Version July 2025
Physicians are encouraged to discuss the use of other blood conservation measures with all patients, including preoperative optimization of iron status and minimizing diagnostic blood draws. Refer to UpToDate for general discussions of patient blood management for further details.
PAD programs are largely the purview of blood collection centers working in collaboration with the hospital-based transfusion medicine service. Patients can donate up to one unit per week, with the last unit collected two weeks prior to surgery. They should begin oral iron supplementation as soon as surgery is scheduled. Autologous blood should never be transfused simply because it is available or would otherwise be discarded. Refer to UpToDate topic on PAD for details.Hb: hemoglobin; PAD: preoperative autologous blood donation; RBC: red blood cell.
* Lower limits of the reference range differ for female and male patients; judgment can be used, especially if the hemoglobin is slightly below or above the lower limit of the reference range. Conditions that would be exacerbated by mild anemia include cardiac ischemia and heart failure.
¶ Common reasons allogeneic transfusion may not be a good option include lack of sufficient allogeneic units for a patient with multiple alloantibodies or an alloantibody to a high-frequency RBC antigen, or reasons to decline allogeneic transfusion such as with Jehovah Witnesses.