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The purpose of this study was to assess the success or otherwise of the introduction of an autologous blood programme in support of cardiac surgery in reducing patient exposure to allogeneic blood products and to assess the guideline of two units as the collection schedule for such patients. Sixty-six patients were enrolled in the programme provided they met defined clinical conditions and donated one, two or three units of blood at seven-day intervals, using isovolaemic conditions. One minor vasovagal adverse reaction was recorded. Of the 66 patients, 51 (77%) avoided allogeneic red cells and 42 (64%) received no allogeneic product. If each patient deposited two units, 51 (77%) would have required no allogeneic red cells; if three units were deposited, 57 (86%) patients would have required no allogeneic red cells, but 60 units would be surplus to requirements. Comparison of 52 patients for coronary artery bypass grafting who were autologous donors, with 130 patients undergoing the procedure before the availability of autologous blood, supports the suggestions that there is increased readiness to initiate transfusion of autologous blood and that exposure to allogeneic red cells is reduced. However, exposure to allogeneic products of all kinds is not reduced. It is concluded that the collection of two units of autologous blood is appropriate for most eligible patients and that this reduces exposure to allogeneic red cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Since April 1975 the proficiency of laboratories in Ontario that perform immunohematology tests has been assessed. While the majority of test samples have required only ABO and Rh(D) typing, others have posed problems. The error rate in uncomplicated ABO typing was 1.3/1,000 in 17,479 tests and that in straightforward Rh(D) grouping, 6.6/1,000 in 17,757 tests. False-negative (36/1,000) and false-positive (1.4/1,000) direct antiglobulin tests occurred. Errors in detection of strong alloantibodies (e.g., anti-D) were 19.7, 10.2 and 5.1/1,000 in three test samples. A2B or A2 cells with anti-A1 in serum were sent out in two surveys; error rates in ABO interpretation were 189 and 52/1,000, respectively. Laboratories also experienced difficulty in interpreting the Rh(D) type of cells with positive antiglobulin tests. These surveys have had several effects: (1) laboratories with poor performance have been identified, (2) patterns of practice have been influenced, (3) areas of ignorance have been identified, and (4) a stimulus has been provided for continuing education in immunohematology.