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The Role of Autologous Blood Transfusion in Adolescents Undergoing Spinal Surgery

Moran, M M, MD; Kroon, D, RN*; Tredwell, S J, MD†,‡; Wadsworth, L D, MB, ChB*

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Study Design A prospective study of 147 consecutive patients undergoing spinal surgery who were analyzed for response to an effect of an offered autologous blood program.

Objectives Analysis of the impact of the autologous program within a comprehensive blood conservation philosophy toward the reduction in the use of homologous blood.

Methods Each patient was prescreened by the autologous program for inclusions and ability. Physical parameters were recorded as were predonation and postdonation hemoglobin levels. The volume of each donation and the number of autologous and homologous units transfused and total operating blood loss were recorded as were complications during donation and transfusion.

Results One hundred sixteen of the original one hundred forty-seven patients participated in the program and donated between 150 and 1900 ml of blood during the preoperative period. Of these, 35 patients weighed 45 kg or less. Diagnoses included 97 cases of idiopathic scoliosis and the remainder had spinal deformities of other causes. Of the entire group, 13 patients (11%) received homologous blood transfusion, 7 of these patients had diagnoses other than idiopathic scoliosis.

Conclusions In this study of 116 patients, 89% of the spinal surgeries were successfully completed using only autologous blood. This compared favorably with a historical control group in which 60% of the patients required homologous blood transfusion. It is concluded that the use of autologous blood donation combined with other blood conservation techniques has significantly lessened the need for homologous transfusion.

*From the Departments of Pathology, British Columbia's Children's Hospital, Vancouver, British Columbia

†From the Orthopedic Surgery, British Columbia's Children's Hospital, Vancouver, British Columbia

‡From the Department of Orthopedic Surgery, University of British Columbia, Vancouver

© Lippincott-Raven Publishers.