Blood Management for Surgery

Are you scheduled for surgery? If so, you may worry about the need to replace blood lost during surgery. The goal is to keep the body's normal levels of blood. Blood transfusion is a way to reach this goal. Your doctor can tell you more about how to bank your own blood and other ways to get ready for surgery. Be sure to talk with your doctor about the risks and complications of the different blood management methods. Also talk about possible alternatives to blood transfusion.

Take some time to plan for your blood management. Blood tests are done to check your blood levels. They also check if you have low red blood cell count (anemia). You need to be in good health and without health problems if you are banking your own blood. There are also certain weight requirements. You may also need to sign a consent form. Also be sure to tell your doctor if you are taking any medicines, vitamins, herbs, or supplements.

You may be able to donate and bank your own blood before surgery for later transfusion. This is called autologous blood donation. Your banked blood is replaced during or after surgery as needed. Autologous donations need advance planning. The time depends on the amount of blood needed. Another choice for autologous blood transfusion is to save blood that is lost during surgery. This blood is then returned to your body during or after surgery, if needed. Your own blood is the safest blood you can receive. The risks of getting a disease or an allergic reaction are very low. But in some cases you may also get donor blood if you were unable to donate enough blood before surgery. In some cases during surgery, a cell salvage device may be used to collect the blood that you lose during surgery. The device then washes or filters the blood and returns the collected blood back to your body.

If you are not able to donate for yourself, you may get blood donated by another person (blood bank donor). This is called allogeneic blood donation. This type of blood is screened for disease. And it's ready to use right away. Family and friends with your blood type can also donate blood for your use. This is called a designated or directed donor. Time is still needed to screen the blood for disease. Know that bank blood is considered safe.

If you have a health condition, such as anemia, you may not be able to donate your own blood. If you are scheduled for elective surgery that's not cardiovascular, another choice for blood management includes injections of a medicine called epoetin alfa (erythropoietin). This medicine helps increase the amount of red blood cells in the blood. It also reduces the need for allogeneic blood transfusion. Epoetin alfa is given each day or each week at a doctor's office. Or you can be taught to give yourself the injections.

If you are donating your own blood or if you have anemia, you may need extra iron. Your doctor may prescribe an iron supplement. Take it with vitamin C so it will be absorbed better. Some foods, medicines, and supplements can interfere with absorption of iron from the intestines. Eating foods that contain iron may also help you. Iron-rich foods include red meat, beans, nuts, and raisins. In some cases, you may need I.V. (intravenous) iron to help you prepare for surgery. Follow your doctor's specific instructions.