Considerations For Autologous Blood Donation Before Surgery

Why You May Not Need To Donate Blood Prior To Having Surgery

Donating your own blood before surgery was started in response to the initial AIDs epidemic. This practice was seen as early as the 1980’s. However, great strides have been made and accomplished in making the U.S. blood supply very safe. Here are some considerations before you decide to donate your blood before surgery.

Donating Blood Is A Process Through Which You Experience A Blood LOSS

While the body normally carries a blood volume of 8-12 pints (units) and can easily afford to give up one of those units, there are other considerations when making the decision to self-donate your blood. Those things include age, other co-morbities (other health problems, i.e. heart disease), the type of surgery that you are having, and your general state of health. Giving blood depletes your hematologic (blood making) system. The marrow (inside the bone), which manufactures red blood cells, suffers a shock of sorts when blood is removed from the body. As a result, it rushes to respond to the loss. Along with the marrow, the other systems of the body react to blood loss. (Yes, it is a blood loss of one full unit each time you donate!) When the body experiences a blood loss, the heart, lungs, kidneys, liver and brain-your major and essential organs, as well as your metabolic function are affected. They must work over-time to accommodate the blood loss. (Ever fainted or felt like fainting after donating blood? Your body has issued a statement to you that something just happened to it!) The body experiences shock in mild or major ways in response to a shift in its normal equilibrium (homeostasis is the medical term for this). Therefore, your whole body is going to rush to make sure that equilibrium is restored.

How Long Does It Take For Blood Volume To Replenish Itself?

The National Kidney and Transplant Foundation states that the PLASMA portion (about 80% water, but NOT 80% of your total blood loss volume-big difference) is replaced in 24-48 hours. However, it takes 3-5 WEEKS to replace the red blood cell (RBC’s or packed cells) portion of the loss. When considering surgeries, especially moderate-to-high blood loss surgeries, it is important to understand that autologous blood expires after 28 days and cannot be used. (It also cannot be given to someone else other than yourself because it has not gone through the special preparation require to enter the pool of general blood donations offered to the public.)

So, if you donate your own blood and 2 weeks later have a moderate-to-high blood loss surgery (i.e. joint or back surgery, some types of abdominal surgery, or cardiovascular surgery) you will be going into the procedure somewhat compromised. Additionally, you will experience a blood loss of minimal to large proportions, depending on the procedure and any unforeseen complications within or after surgery. Now, certainly you have your “auto-unit” available, if needed, but why deplete yourself only to get it back? Did you really need it in the first place? If you had not given it would you have needed transfusion? And if there is further blood loss during or after surgery (i.e. via post-operative drains from your incision), consider that you may need not only your auto-unit, but also a donor unit or units of blood. If so, the purpose of auto-donation is somewhat defeated. There is clinical evidence that has been sited that states that auto-donation increases the likelihood of peri-operative (the time during and after surgery) blood transfusion in surgeries such as hysterectomy. Additionally, there is some evidence that patients are at risk of ischemic (decreased blood flow) events to organs like the heart, causing myocardial infarction (heart attack).

Other Considerations

There are other considerations when thinking about whether to donate your own blood for surgery. Your age, the sate of your health, your level of physical fitness, recent health history, and number of surgeries within short time spans are just some of the considerations. If you are of advanced age, have other health problems that will affect your surgical outcomes and recovery, have a “heart history” (heart attack, chest pain/angina, artificial valves, etc.) you may want to think twice about auto-donating. While the standard of care for orthopedic surgeries such as joint replacement is for a patient to auto-donate before surgery, it is NOT for everyone. Ask questions, and expect answers before doing so. You can also research for yourself, as there are many internet sites that provide lots of good information to help you with making your decision. Always remember that the last word is with YOU. If you don’t feel comfortable about things, wait, ask more questions, and make the decision that’s best for you.

Do You Need a Health Care Advocate?

Health advocacy is not a new idea, however, with the ever increasing complexity of the health care systems of the world, it is fast becoming a specialized area of expertise. So what exactly does a health care advocate do? The possibilities are varied, but, in a nutshell, a health care advocate is a liaison between patients, their families, and members of the health care profession or its systems of administration.


When a person is ill, especially with chronic, debilitating or critical and complex conditions, an advocate is a welcome intermediary who can help a patient and/or their family make complex medical decisions or sort through the complexities of health insurance coverage issues. Also, because an advocate is most likely going to be a medical professional who is familiar with the medical community, he or she can make unbiased recommendations for care in a variety of settings, with a variety of providers. An advocate should possess "insider information," and be able to, without conflict of interest, help a person or family choose quality care providers/organizations/facilities, and get assistance from insurance companies when insurance issues arise.


Why would you need a health care advocate? Aside from the aforementioned, the biggest reason I can think of is that a person who is not well indoctrinated in the workings of the human body, and doesn't understand diagnostics, treatments, and current standards of care may have difficulty negotiating through even the simplest of medical problems. So when a person has more complex health issues, in order to arrive at totally informed consent, and receive a balanced and unbiased opinion about how to proceed, an advocate may be useful.

Remember-during times of illness emotions can run high and out of control. Decision-making skills and capacities are compromised. An advocates job is to present facts and truth without emotion, giving you a balanced, hopeful approach, so that decisions are made that are in the patients best interest.

Do you, or someone you know need a health care advocate? If you're not sure, here are some things that may help you decide:

1.) You believe the physician responsible for your care is not responsive to your needs and concerns, or you believe that you need other treatment and he/she will not refer you to a specialist.

2.) You wonder whether you are on too many medications.

3.) People who care about you are telling you to seek out another opinion, but you don't know where to go.

4.) You have a loved one in the hospital and you aren't getting answers to your questions about their condition or their medical care, or you need help understanding what is happening or is going to happen in the days ahead.

5.) You need help mapping out long term care plans for yourself or a loved one.

6.) Your insurance company is denying care, and you need to know what to do, or what alternatives that you have.

7.) You need help because you cannot afford to pay for your medications.

These are just a few reasons to hire a health care advocate. While any one of the aforementioned reasons, standing alone, could be handled by yourself, just imagine what it would be like to have to manage several of these things at once without having expert knowledge.

While there is a cost to retaining a health care advocate, the savings realized in time, energy exerted and frustration are all well worth the expenditure. The realization that you or your loved one have access to privileged information and help negotiating specialized care are priceless. Don't hesitate to use an advocate: you'll be glad that you made the call.