Autologous blood transfusion in oral and maxillofacial surgery patients with the use of erythropoietin

Christopoulou, Maria; Derartinian, Harry; Hatzidimitriou, G; Iatrou, Ioannis

doi:10.1054/jcms.2001.0200

Cited by 10 publications

(11 citation statements)

References 22 publications

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“…Participants in Billote 2002 predonated two units, although two patients only donated one unit. In Christopoulou 2001 24 patients predonated two units while four others undergoing bimaxillary osteotomies, donated two units. In Bouchard 2008 two units of 350 mL were predonated.…”

Section: Resultsmentioning

confidence: 99%

“…In Billote 2002, whole blood was donated once a week with the final unit collected no later than two weeks prior to surgery. Participants in the trial by Christopoulou 2001 donated at least one week before the operation and the time between donations was one week. Bouchard 2008 reports that patients donated blood weekly and that blood was stored for a maximum of 35 days.…”

Section: Resultsmentioning

confidence: 99%

“…In Bezwada 2003 the PAD group received oral supplementation of 325 mg iron sulphate three times a day. In Christopoulou 2001 all patients received 150 mg ferrous sulphate orally each day until one week post-operation. Bouchard 2008 gave patients in the PAD group 300 mg ferrous sulfate orally, three times daily throughout the period between recruitment and surgery.…”

Section: Resultsmentioning

confidence: 99%

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Pre-operative autologous donation for minimising perioperative allogeneic blood transfusion

Henry

Carless

Moxey

et al. 2001

Cochrane Database of Systematic Reviews

138

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Background Public concerns regarding the safety of transfused blood have prompted reconsideration of the indications for the transfusion of allogeneic red cells (blood from an unrelated donor), and a range of techniques designed to minimise transfusion requirements. Objectives To examine the evidence for the efficacy of pre-operative autologous blood donation (PAD) in reducing the need for perioperative allogeneic red blood cell (RBC) transfusion. Search methods Articles were identified by searches of the electronic databases; MEDLINE (January 1950 to July 2009), EMBASE (January 1980 to Week 31, 2009), ISI Web of Science (inception to August 2009), The Cochrane Library 2009, Issue 3, and The Cochrane Injuries Group Specialised Register (searched August 7 2009). Reference lists in relevant publications were checked and authors were contacted to identify additional studies. The searches were updated in August 2009. Selection criteria Randomised controlled trials with a concurrent control group in which adult patients, scheduled for non-urgent surgery, were randomised to PAD, or to a control group who did not receive the intervention. Data collection and analysis Data were independently extracted and the risk of bias was assessed. Relative risks (RR) and mean differences (MD) with 95% confidence intervals (CIs) were calculated. Data were pooled using a random-effects model. The principal outcomes were the proportion of patients exposed to allogeneic red blood cells (RBCs) and the amount of blood transfused. Other clinical outcomes are detailed in the review. Main results Fourteen trials were included. Overall PAD reduced the risk of receiving an allogeneic blood transfusion by a relative 68% (RR 0.32; 95% CI 0.22 to 0.47). The absolute reduction in risk of allogeneic transfusion was 44% (risk difference (RD) −0.44; 95% CI −0.68 to −0.21). In contrast, the results show that the risk of receiving any blood transfusion (allogeneic and/or autologous) is increased by PAD (RR 1.24; 95% CI 1.02 to 1.51). There was evidence of significant heterogeneity for both of these outcomes. Authors’ conclusions Although the trials of PAD showed a reduction in the need for allogeneic blood, the methodological quality of the trials was poor and the overall transfusion rates (allogeneic and/or autologous) in these trials were high, and were increased by recruitment into the PAD arms of the trials. This raises questions about the true benefit of PAD. In the absence of large, high quality trials using clinical endpoints, it is not possible to say whether the benefits of PAD outweigh the harms.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Pre-operative autologous donation for minimising perioperative allogeneic blood transfusion

Henry

Carless

Moxey

et al. 2001

Cochrane Database of Systematic Reviews

138

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“…14 Existen otras estrategias de ahorro de hemoderivados como la hemodilución normovolémica, la cual puede evitar hasta un 89% de las transfusiones alogenicas, 15 la hipotensión controlada, 16 la reinfusión de la sangre lavada y centrifugada desde el campo operatorio 17 y el uso de eritropoyetina. 16,18…”

Section: Discussionunclassified

“…15 Such blood-sparing measures include controlled hypotension, 16 reinfusion of washed and centrifuged blood harvested from the operating field, 17 and the administration of erythropoietin. 16,18…”

Section: Conclusionesmentioning

confidence: 99%

Análisis de la transfusión sanguínea alogénica en cirugía oncológica oral y maxilofacial: Análisis de variables

Guillen

Requejo

Rivera

et al. 2008

Rev Esp Cirug Oral y Maxilofac

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Resumen: Objetivo. Analizar las variables que influyen en los pacientes transfundidos y sometidos a cirugía oncológica. Material y método. Se han revisado y analizado los datos de 44 pacientes intervenidos quirúrgicamente de neoplasia, a los que se les ha practicado transfusión sanguínea peri operatoria, evaluando: edad, sexo, localización de la lesión, código de diagnostico, tratamiento realizado, hematocrito preoperatorio, hemoglobina preoperatoria y hemoglobina pretransfusional, numero de unidades transfundidas, estadio TNM, riesgo ASA y tiempo quirúrgico. Resultados. 44 pacientes fueron transfundidos, 32 varones, con una media de edad de 65 años y con localización lingual en un 36,36%. La cirugía mas frecuente fue la exéresis tumoral asociándose resecciòn ósea y vaciamiento cervical en el 56,82% y con reconstrucción simple en el 63% de los casos. La duración media fue 5,7 horas, con un riesgo ASA medio de 3 y con una media de 2,9 unidades transfundidas. Un 70% se encontraban en estadio IV. La Hb pretransfusional fue de media 7,71 g/dl. El tiempo quirúrgico, la Hb preoperatoria y el HTC preoperatorio son las variables que ha resultado estadísticamente significativas en el análisis multivariante. Conclusiones. La transfusión sanguínea alogénica presenta una serie de efectos adversos que pueden condicionar la evolución del paciente oncológico, para evitar o disminuir estos efectos deletéreos se debe mantener criterios transfusionales restrictivos con Hb<8 g/dl, debemos actuar sobre la Hb preoperatoria, como única variable en la que podemos incidir para disminuir el volumen transfundido y promover programas de ahorro de hemoderivados. Abstract: Objective. Analyze the variables that influence blood transfusion in patients undergoing surgery for cancer.Material and method. Data from 44 patients who underwent surgery for neoplasms and required perioperative blood transfusion was analyzed to evaluate: age, sex, tumor location, diagnostic code, treatment, preoperative hematocrit, preoperative hemoglobin and pretransfusion hemoglobin, number of units transfused, TNM stage, ASA risk, and surgical time. Results. Forty-four patients received transfusions (32 men). The mean age of patients was 65 years and the tumor was lingual in 36.36%. The most frequent intervention was tumor exeresis, which was associated with bone resection and cervical lymph node clearance in 56.82% of cases and with simple reconstruction in 63% of cases. The mean duration of the intervention was 5.7 hours, mean ASA risk was 3, and mean transfusion volume was 2.9 units. Seventy percent of patients had stage IV tumors. Mean hemoglobin concentration before transfusion was 7.71 g/dl. Surgical time, preoperative hemoglobin concentration, and preoperative hematocrit were statistically significant in multivariate analysis. Conclusions. Allogeneic blood transfusions originate adverse effects that can condition the evolution of patients with cancer. Strict transfusion criteria should be followed (Hb < 8g/dl) to prevent or diminish these deleterious effe...

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Blood Transfusion Prediction in Patients Undergoing Major Head and Neck Surgery With Free-Flap Reconstruction

Shah¹,

Goldstein²,

McCluskey³

et al. 2010

Arch Otolaryngol Head Neck Surg

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Autologous blood transfusion in oral and maxillofacial surgery patients with the use of erythropoietin

Cited by 10 publications

References 22 publications

Pre-operative autologous donation for minimising perioperative allogeneic blood transfusion

Pre-operative autologous donation for minimising perioperative allogeneic blood transfusion

Análisis de la transfusión sanguínea alogénica en cirugía oncológica oral y maxilofacial: Análisis de variables

Blood Transfusion Prediction in Patients Undergoing Major Head and Neck Surgery With Free-Flap Reconstruction

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