Allogeneic Transfusion after Predonation of Blood for Elective Spine Surgery

Abstract

The literature suggests preoperative autologous blood donation in total joint arthroplasty is associated with increased overall transfusion rates compared with nondonation and is not cost-effective for all patients. We asked whether the amount of intraoperative blood loss and blood replacement differs between autologous donors and nondonors in elective spine surgery and whether the rates of allogeneic blood transfusions differ between the two groups; we then determined the cost of wasted predonated units. We retrospectively reviewed 676 patients who underwent elective lumbar spine surgery and compared relevant data to that in a matched cohort of 51 patients who predonated blood and 51 patients who received only cellsaver blood and underwent instrumented spinal fusion.

Postoperative Anemia Following Posterior Decompression Surgery for Lumbar Spinal Canal Stenosis

“…The types of surgery vary and the levels to be operated differ for each case. For invasive surgeries such as fusion surgery and scoliosis surgery, the management to prevent allogenic transfusion has been examined (Behrman and Keim 1992;Chanda et al 2002;Brookfield et al 2008;Gause et al 2008;Savvidou et al 2009). However, for less invasive surgery such as decompression surgery, postoperative anemia has not been evaluated in detail.…”

“…Previous reports have discussed the efficacy of intraoperative cell saver blood autotransfusion to prevent allogenic transfusion (Behrman and Keim 1992;Chanda et al 2002;Brookfield et al 2008;Gause et al 2008;Savvidou et al 2009). However, these reports did not compare intraoperative and postoperative bleeding volume.…”

The pattern of blood loss in adolescent idiopathic scoliosis

“…A nonrandomized study has even showed increased blood loss in the cell-saver group [20]. Preoperative autologous blood donation has had mixed reports in the literature [21][22][23][24][25].…”

Pre-Operative Autologous Blood Donation Does Not Affect Pre-Incision Hematocrit in Adolescent Idiopathic Scoliosis Patients. A Retrospective Cohort of a Prospective Randomized Trial

“…19 Allogenic transfusion also increase the risk of infectious disease such as hepatitis B and C, HIV and nvCJD. 19 Predonation has several limitation in major spinal surgery such as difficulty of predicting which patients require blood tranfusion, 20,21 the high potential for wastage (up to 40% discarded autologous blood products), 20 a high level of communication across a variety of specialties necessary for successful implementation, and its inavailability in emergency surgeries. 4 With the exception of the estimated blood volume, the baseline demographic variables between the PD and non-PD groups were similar.…”

“…20 Similarly, Kennedy et al examined elective posterior lumbar spine surgery in adult patients and found PD induced preoperative anemia. 7 The authors found preoperative Hct in patients who pre-donated was significantly lower (39.8 ± 4.5 vs 41.6 ± 4.6, p<0.001).…”