Is Autologous Blood Transfusion cost effective in Adolescent Idiopathic Scoliosis?

The purpose of this study has been to evaluate the use of preoperative autologous blood donation (PABD) in the surgical treatment of adolescent idiopathic scoliosis (AIS). The surgical records of 37 AIS patients, Lenke type 1, were reviewed. Patients were classified according to whether they had entered the PABD (Program of Autologous Blood Donation) (25 patients) or had been rejected to join (12 patients non-donors). Both groups were comparable. All but one of the PADB patients (96%) as compared to only 2 non-donors patients (16.7%) required post-operative transfusion. Moreover, 12 of the PABD patients (48%) did not require the whole stored blood. At discharge both groups had similar haemoglobin levels. The risk of transfusion was much higher in the PABD group. The patients in this group received blood even with high haemoglobin levels (>8 g/dl). Furthermore, 31.4% of the collected blood was never used. Therefore, PABD resulted in an increase in procedure costs and lead to unnecessary blood transfusions.