Hillyer et al evaluated autologus blood donation in donors with high-risk medical conditions. In general a patient healthy enough for elective surgery is capable of donating blood provided certain precautions are taken. The authors are from Emory University in Atlanta.


Conditions that should defer the patient from making an autologous donation:

(1) refractory angina pectoris severe enough to require hospital admission

(2) severe mitral stenosis

(3) hematocrit < 33%


Conditions associated with untoward donor reactions on multivariate analysis:

(1) first-time donor

(2) therapy with a cardiac glycoside


The authors found no difference in the rate or severity of donor reactions in patients with the following high-risk conditions versus those who did not have them. However, it may be prudent to monitor the patient more closely and to have ready access for response in the event of a problem.


High-risk cardiac conditions:

(1) significant coronary artery disease (other than refractory angina, above)

(2) significant cardiac arrhythmias

(3) significant heart failure

(4) significant valvular heart disease other than severe mitral stenosis (see above)

(5) significant congenital heart disease


Other conditions that may be associated with a high-risk donation:

(1) significant cerebrovascular disease

(2) history of recent seizures

(3) hypertension requiring 2 or more antihypertensive drugs for control, or uncontrolled

(4) significant dyspnea

(5) insulin-dependent diabetes mellitus


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