Applications of acute normovolemic hemodilution combined with autologous transfusion salvage in the surgery for patients with RH(D) negative rare blood type

Objective To explore the security and feasibility of application of acute normovolemic hemodilution(ANH) combined with autologous transfusion salvage in the surgery for patients with RH(D) negative rare blood type. Methods 20 patients with RH(D) negative rare blood type for surgery were given ANH combined with autologous transfusion salvage after general anesthesia.Then,changes of HBG,HCT,PLT,APTT,PT and FIB in the preoperative(T0),posthemodilution time(T1),before blood transfusion(T2),after autologous transfusion(T3),and after collection of whole blood transfusion(T4) of all patients were observed and compared.In addition,the volume of blood collection in ANH and the volume of red blood cells recycle and washed were recorded. Results The average volume of blood collection for ANH of all patients was(590.00±137.27)ml.The intraoperative average volume of recycling washed red blood cells was(562.50±179.09) ml and 0 ml of allogeneic blood was transfused.There were statistical differences in different periods of HBG,HCT,PLT,APTT,PT and FIB(P0.01).No significant statistical difference was found in the comparison of APTT,PT between T0 and T1(P0.05),while it was found between T2 andT0,T3 and T2,T4 and T3(P0.01).But the differences were still within the range of the normal reference value.There was statistically significant difference in the comparison of HBG,HCT,PLT,FIB between T0 and T1,T2 and T0,T3 and T2,and T4 and T3(P0.01). Conclusion The application of acute normovolemic hemodilution combined with intraoperative autologous transfusion salvage can save blood resource,avoid allogeneic transfusion and solve the problem of scarcity of RH negative blood source.It can be safely applied in surgeries for patients with RH(D) negative rare blood type.