[Autotransfusion and hemodilution in orthopedic surgery in children]

The risk of transmitting viral diseases is a constant worry for those who perform blood transfusions. In the last three years several techniques were used to avoid homologous blood transfusions. Four series of patients were evaluated: 1st series: Only homologous blood transfusions (27 cases); 2nd series: Acute normovolaemic haemodilution during surgery (20 cases); 3rd series: Autologous blood storage prior to surgery and haemodilution during surgery (20 cases); 4th series: Blood storage prior to surgery + haemodilution + Trinitine perfusion during surgery (44 cases). 111 patients having undergone vertebral arthrodesis and 13 children having undergone orthopaedic or repair surgical procedures are reported. In the first series, 98 per cent of blood loss was replaced by homologous transfusions, in the second series, 46 per cent, in the third series, 19 per cent, in the fourth series, less than 5 per cent. This study provides confirmation that in cases of major pediatric orthopaedic surgery, it is possible to use the various techniques demonstrated to avoid homologous transfusions.