Controversies Regarding Compatibility in Xenotransfusion With Blood From Dog to Cat (Review)

As it is well known, any incompatible blood transfusion can generate adverse reactions in feline patients, because cats naturally have plasmatic alloantibodies. Even so, recent scientific studies have shown that transfusions with heterologous blood (canine) to cats, were indeed followed by mild hemolysis states, in cases of severely anemic patients. A repeated transfusion however will cause anaphylactic shock with fatal outcome. Based on the data we have studied, we consider xenotransfusion, even though still controversial, to be considered as an emergency therapeutic procedure when superior, homologous blood cannot be acquired for felines. Through this review we hope to offer clinicians the necessary information to consider xenotransfusion as an alternative in emergency therapy, when this is rigorously sustained by blood compatibility tests and when all other options have been excluded only.

Comparison of the efficacy of autologious blood transfusion combined with preoperative hemodilution, with homologous blood transfusion in patients undergoing elective surgical procedure

Background: To study the changes in haemogram and coagulation profile in patients undergoing autologous and homologous blood transfusion and suitability of the technique of autologous blood transfusion in routine blood bank management.Methods: Patients who were waiting to undergo elective surgical procedures were randomly distributed in two groups, Group A: Autologous blood transfusion, with or without haemodilution: wherein pre-operative period a predicted volume of blood was collected and Group B: Homologous blood transfusion: where required blood was arranged from Blood Bank. The cardiovascular status, the haemogram and the coagulation profile were recorded at various stages.Results: Out of 240 patients registered only 43 could fulfil the basic requirements only 25 could be motivated in each group. In Group A cases were of age group 51-60 years while it was 41-50 years in Group B. Male:Female ratio was 2:1. 47 Units were retransfused to Group A patients, Group B cases received 45 blood transfusions. In Group A patients 8% cases showed mild hypotention and 1% showed mild hypersensitivity to Haemacel. In Group B, 40% cases showed transfusion reactions. Fall in Hb was lesser in Group A (2.4) on first and (1.7) on second postoperative day compared to Group B (3.3) on first and (2.7) on second postoperative day. The haematocrit levels declined more sharply after operation in Group B (7) rather than Group A (10.4).Conclusions: Advantage of avoiding transfusion reactions, major changes in blood parameters, entry of infections proves Autologous blood transfusion to be the safest, cost effective and easy form of transfusion therapy.

Accuracy of predicted haemoglobin concentration on cardiopulmonary bypass in paediatric cardiac surgery: effect of different formulae for estimating patient blood volume

Introduction: When applying a blood-conserving approach in paediatric cardiac surgery with the aim of reducing the transfusion of homologous blood products, the decision to use blood or blood-free priming of the cardiopulmonary bypass (CPB) circuit is often based on the predicted haemoglobin concentration (Hb) as derived from the pre-CPB Hb, the prime volume and the estimated blood volume. We assessed the accuracy of this approach and whether it may be improved by using more sophisticated methods of estimating the blood volume. Patients and Methods: Data from 522 paediatric cardiac surgery patients treated with CPB with blood-free priming in a 2-year period from May 2013 to May 2015 were collected. Inclusion criteria were body weight <15 kg and available Hb data immediately prior to and after the onset of CPB. The Hb on CPB was predicted according to Fick’s principle from the pre-CPB Hb, the prime volume and the patient blood volume. Linear regression analyses and Bland-Altman plots were used to assess the accuracy of the Hb prediction. Different methods to estimate the blood volume were assessed and compared. Results: The initial Hb on CPB correlated well with the predicted Hb (R2=0.87, p<0.001). A Bland-Altman plot revealed little bias at 0.07 g/dL and an area of agreement from -1.35 to 1.48 g/dL. More sophisticated methods of estimating blood volume from lean body mass did not improve the Hb prediction, but rather increased bias. Conclusion: Hb prediction is reasonably accurate, with the best result obtained with the simplest method of estimating the blood volume at 80 mL/kg body weight. When deciding for or against blood-free priming, caution is necessary when the predicted Hb lies in a range of ± 2 g/dL around the transfusion trigger.