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The use of autologous blood transfusions in pediatric orthopaedic surgery
J M Flynn1, K Cintrón, R M Canals
1Department of Orthopaedic Surgery, University of Puerto Rico School of Medicine, San Juan 00936-5067.
Insights
Autologous blood transfusions are safe and effective for pediatric spinal fusion patients, reducing the need for homologous blood. This method enhances blood availability for surgical procedures.
Area of Science:
- Orthopedics
- Transfusion Medicine
- Pediatric Surgery
Background:
- Spinal fusion procedures in pediatric patients can involve significant blood loss.
- The use of homologous blood transfusions carries potential risks and challenges.
- Autologous blood donation is an alternative strategy to mitigate these risks.
Purpose of the Study:
- To evaluate the efficacy and safety of pre-deposited autologous blood transfusions in pediatric spinal fusion surgery.
- To assess the impact of this method on the requirement for homologous blood transfusions.
- To determine patient acceptance and feasibility of the autologous blood program.
Main Methods:
- Review of medical records for 29 pediatric patients (ages 8-25) undergoing spinal fusion.
- Pre-operative oral iron supplementation and phased phlebotomy for autologous blood collection (1 unit every 6 days if hematocrit >34%).
- Storage of whole blood with adenine saline solution (ADSOL) for up to 35 days.
Main Results:
- 89% of patients received only autologous blood transfusions.
- Average autologous blood donation was 3.17 units (1,427 ml).
- Average pre-operative hematocrit was 35%; homologous blood was needed in only 11% of cases.
Conclusions:
- Pre-deposited autologous blood transfusions are a safe, easy, and well-accepted method for pediatric spinal fusion.
- This approach effectively reduces the need for homologous blood transfusions.
- The program contributes to increasing blood reserves at blood banks.
Abstract:
This study reviews the medical records of 29 patients that were submitted to 29 spinal fusion procedures with the purpose to evaluates the efficacy of using predeposited autologous blood transfusions to replace operative blood loss. The patients age ranged from 8 to 25 years. Each patient was started on oral iron supplement as soon as surgery was scheduled. The phlebotomies were performed at the American Red Cross Blood Services Puerto Rico Chapter. Blood was drawn 1 unit every 6 days if the hematocrit was above 34%. The last phlebotomy was performed at least 7 days before surgery. The average amount of blood donated was 3.17 units (1,427 ml). The whole blood was stored using the adenine saline solution (ADSOL) as preservative for as long as 35 days. The average preoperative hematocrit value was 35%. In 89% of the cases only autologous blood was transfused. In the rest of the cases family donated homologous blood was required. The use of pre deposited autologous blood for replacement of operative blood loss has proven to be a safe, easy and well accepted method for the pediatric age patients. It also reduced the need for homologous blood and helps to increase the blood reserve at banks.