SCOPE AND DEFINITION

Predeposit autologous donation (PAD) is the collection and storage of blood from a person prior to elective surgery so that it can be transfused to the same person in the event that a transfusion is required due to blood loss or anaemia.^3–5 This guideline does not cover other forms of autologous donation, such as cell salvage, acute normovolaemic haemodilution and emergency autotransfusion. PAD is no longer recommended except for the exceptional circumstance outlined below.

BACKGROUND AND CURRENT CONTEXT

PAD came into being at a time when one of the largest concerns about blood transfusion was the risk of transmission of infection, in particular human immunodeficiency and hepatitis viruses in the 1980s. PAD was a means of decreasing infection risk.³

In the last 30 years, the management of preoperative anaemia and blood loss during surgery has changed significantly. There remains a small group of patients who, despite clinicians utilising patient blood management techniques, may still require intraoperative or postoperative red cell transfusion and where the blood services cannot provide compatible allogeneic blood. It must, however, be borne in mind that the greatest risks of transfusion relate to administrative error. The risk of such errors will be increased by introducing such a rarely performed variation from normal practice, as would be the case for PAD. One infectious risk of blood component transfusion is bacterial contamination, which may also be paradoxically increased by a non-standard process and longer storage.