Predeposit autologous donation in spinal surgery: a multicentre study

Area of Science:

• Orthopedic Surgery
• Transfusion Medicine
• Anesthesiology

Background:

• Allogeneic blood transfusions (ABT) are frequently required in elective spine surgery due to perioperative blood loss.
• Preoperative autologous blood donation (PABD) is a primary strategy to mitigate the need for ABT.
• This study investigates the efficacy of PABD in spine surgery and the role of recombinant human erythropoietin (EPO).

Purpose of the Study:

• To determine the yield and efficacy of PABD in elective spine surgery.
• To assess the effectiveness of PABD in different types of spine surgeries (fusion vs. scoliosis).
• To evaluate the potential role of recombinant human erythropoietin (EPO) in facilitating PABD.

Main Methods:

• Retrospective review of hospital charts and blood bank records for spine surgery patients undergoing PABD.
• Data collected from 1995 to 2003, including 680 patients categorized into spinal fusion and scoliosis surgery groups.
• Analysis of PABD completion rates, transfusion rates, ABT avoidance, blood wastage, and EPO administration.

Main Results:

• 92% of patients completed PABD, with 80% successfully avoiding ABT.
• PABD was significantly more effective in spinal fusion (86%) compared to scoliosis surgery (47%).
• Blood wastage was 38% overall; EPO administration improved outcomes in anemic patients.

Conclusions:

• PABD serves as an effective alternative to ABT in spine surgery, despite study limitations.
• The effectiveness of PABD can be further enhanced when combined with other blood-saving strategies.
• PABD is a valuable component of perioperative blood management in spine surgery.