Feasibility of a Predeposit Autologous Blood Donation Program in Colorectal Cancer Patients: Results from a Randomized Clinical Study

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Abstract
The hematologic and transfusion data of a multicenter randomized trial investigating the effect of blood transfusions on the 5‐year survival were used to study the feasibility of an autologous blood donation program in colorectal cancer patients. Three hundred and ten patients were randomized for autologous blood transfusions (predeposition of 2 units) or homologous blood transfusions, and transfusion rules were standardized.The Hb level in the patients who donated blood decreased by 20.1 ± 1.3 g/1 (mean ± SEM) preoperatively and 4.5 ± 1.8 g/1 postoperatively, and in controls 3.7 ± 1.1 g/1 and 16.5 ± 1.9 g/1 (significantly different between the two groups, both pre‐ and postoperatively: p < 0.01). Because blood loss and number of transfusions were similar in both groups, this indicated that either preoperative or postoperative erythropoiesis is stronger in patients who had donated blood. Twenty‐three percent of the autologous patients and 61% of the homologous patients were exposed to homologous blood. The effectiveness of the procedure differed per tumor localization. In patients with a right‐sided colon carcinoma, 22% of the control patients needed homologous blood, compared to 10% of the autologous patients. In patients with other colon carcinomas, this was 52 and 16%, respectively, and in patients with a rectal carcinoma 85 and 41%.We conclude that predeposition of 2 units of blood for colorectal cancer surgery is feasible and useful to prevent homologous blood usage in a significant number of patients with left colon carcinoma or rectal carcinoma.