Autologous blood volume

Autologous hematopoietic stem cells are obtained (or harvested ) from bone marrow or peripheral blood. The technique for harvesting autologous hematopoietic cells depends on the anatomic source (i.e., bone marrow or peripheral blood). A surgical procedure is necessary for obtaining bone marrow. Multiple aspirations of marrow are obtained from the anterior and posterior iliac crests until a volume with a sufficient number of hematopoietic cells is collected (i.e., 600-1200 mL of bone marrow). The bone marrow then is processed to remove fat or marrow emboli and usually is infused intravenously into the patient like a blood transfusion. 

Blood is taken aseptically into a flask containing heparin (2500 I.U./100 ml blood). Pularin (Evans Medical Co. Appendix 3) is a suitable source of heparin without preservative. The blood is allowed to stand at room temperature for 40 min and the leukocyte-rich plasma is then withdrawn aseptically and centrifuged at 400 g for 15 min at room temperature. The supernatant is withdrawn and recentrifuged at 1000 g for 10 min at room temperature to give a cell free autologous plasma preparation which can be stored at — 20°C. The cell sediment is resuspended in l/10th the initial volume of autologous plasma. 

A more direct method recommended by Pharmacia (Appendix 3) uses 2 ml whole anticoagulant-treated blood diluted with an equal volume of BSS. This is layered over 3 ml Ficoll-Paque and sedimented at 400 g for 30 min. The lymphocytes may be removed from the interphase and the upper layer may be used as a source of autologous plasma. 

A right atrial catheter has to be placed in the recipient of hematopoietic transplantation. The collected cells are infused freshly, or after rapid thawing in autologous or cord blood transplantation. Infusion duration is variable, from minutes to more than 1 h, depending on the volume to be administered. Vitals have to be monitored every 10-15 min. The main complications of cell infusion are chills, fluid overload and, infrequently, fat emboli in the lungs. 

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