Does intraoperative cell salvage system effectively decrease the need for allogeneic transfusions in scoliotic patients undergoing posterior spinal fusion? A prospective randomized study

Abstract

Cell saver use significantly reduces the need for allogeneic blood in spine deformity surgery, particularly in patients with low preoperative hemoglobin or longer operation time. This study confirms the utility of routine cell saver use during PSF with segmental spinal instrumentation for scoliosis patients.

Duchenne muscular dystrophy: the management of scoliosis

“…This has been shown to reduce the number of blood transfusions required when compared to those who did not use cell-saver technology (52).…”

Influence of Intraoperative Blood Salvage on Surgery for Scoliosis

“…In a prospective, randomized study 4 , the safety and efficacy of the intraoperative cell salvage system in decreasing the need for allogeneic blood transfusions was determined in a cohort of 110 patients with scoliosis submitted to posterior arthrodesis …”

“…Furthermore, there is also the risk of contracting infectious diseases: human immunodeficiency virus (HIV) 1: 1.930.000, hepatitis B 1: 137.000, Hepatitis C 1: 1.000.000 and bacterial sepsis. 2,4 These risks, although small, have prompted surgeons to look for ways of reducing the number of allogeneic blood transfusions. 4 There are various preoperative and intraoperative techniques reported in the literature to minimize blood loss and the need for a blood transfusion.…”

“…2,4 These risks, although small, have prompted surgeons to look for ways of reducing the number of allogeneic blood transfusions. 4 There are various preoperative and intraoperative techniques reported in the literature to minimize blood loss and the need for a blood transfusion. These include normovolemic hemodilution; hypotensive anesthesia; longer procedures; preoperative autologous blood donation; intraoperative blood salvage (IBS); Cell Saver in the North American literature; autologous growth factor (AGF); recombinant factor VIIA (rFVIIa) and antifibrinolytic agents (aprotinin, tranexamic acid and aminocaproic acid).…”

“…Other advantages are: the absence of transmission of viral diseases, reduced risk of alloimmunization, normal concentration of potassium, considering the fact that the cells are infused at room temperature. 4 It is also a good alternative for patients who refuse to receive blood donations due to religious beliefs. 1 Despite the advantages of this method, it is not clear whether its use decreases the need for allogeneic transfusions in surgeries for scoliosis; some studies have shown a positive association, while others have not.…”