STAFF OFFICERS AS BLOOD SUPPLIERS: EFFECTS OF REPEATED DONATIONS AND AUTOLOGOUS REINFUSIONS OF UNTRANSFUSED UNITS

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Abstract

BACKGROUND

Limited blood inventory and resupply chains in combat settings can result in preventable deaths from traumatic hemorrhage. One way of mitigating this could be to establish donor pools where blood is collected in advance of high-risk missions and then reinfused back to the donor if not needed to treat casualties.

METHODS

450+56 mL blood was collected, rested for 2 hours in room temperature and stored at 4 °C. The blood was reinfused 22-24 hours after donation and the donor observed for adverse reactions. Samples were collected before and 20 minutes after each donation for hematology, IgG, ferritin, CRP, total protein, LDH, bilirubin, haptoglobin and APTT.

RESULTS

9 participants went through a total of 36 donation and reinfusion procedures. 4 donors participated in 5 rounds, 2 in 4 rounds, 2 in 3 rounds, and 1 in 2 rounds. A significant drop was seen in hemoglobin (14.6 ± 0.9 to 13.9 ± 0.9) and ferritin (179 ± 70 to 149 ± 78) from before first donation to after the last reinfusion (p<0.05). Other parameters were unaffected.

CONCLUSION

This small pilot study suggests that repeated donations and reinfusions may be both feasible and safe. Blood collected in this way should be labeled with the donor’s full name and social security number (or similar) and the identity visually verified by the donor immediately before both donation and reinfusion. To further reduce risk, this form of donation should be restricted to scenarios where there is no other option for making blood available.

LEVEL OF EVIDENCE

Therapeutic/care management study, Level V

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