Transfusion management in pediatric and adolescent scoliosis surgery: Efficacy of autologous blood

David J. Murray, Robert B. Forbes, Marvel B. Titone, Stuart L. Weinstein

Research output: Contribution to journalArticlepeer-review

93 Scopus citations

Abstract

Study Design. A retrospective review of consecutive pediatric and adolescent patients who required posterior spinal fusion to correct scoliosis. Objective. To 1) measure the participation of pediatric patients in predeposit programs for autologous and directed blood donation 2) to assess the success of autologous predonation in preventing allogeneic blood use 3) to determine whether transfusion indications difference between patients who received allogeneic blood and those who received autologous blood, and 4) to assess factors that predict transfusion requirements during scoliosis surgery. Summary of Background Data. Authors of recent studies in adults have questioned whether transfusion of autologous blood is a best- effective therapy when compared to the less-expensive alternative-transfusion of allogeneic blood. In children, the efficacy of autologous blood has not been assessed in a large population of surgical patients in adults, the frequency of patient participation, the success of autologous donors in avoiding allogeneic transfusion, and the proportion of collected autologous units used during the perioperative period are measures used to establish the efficacy of autologous predonation programs. Methods. Hospital and clinic records for each patient who underwent posterior spinal fusion from September 1, 1989 through September 1, 1994 were reviewed. Blood bank consultation, autologous donation records, anesthesia records, surgical reports, and hospital records were reviewed. Seventy percent of patients 1764 of 2431 pericipated in autologous donation. Results more than 90% of autologous donors successfully avoided receiving allogeneic blood. Patients with idiopathic scoliosis (n = 188) were more likely to participate in autologous donation (n = 144) and to avoid allogenic blood (n = 135). Patients with neurologic causes of scoliosis more commonly used allogeneic of directed donation (56 of 75 patients). Nineteen patients with neuromuscular causes of scoliosis participated in autologous donation, but more than one half of this group (76 to 79 patients) required allogeneic blood in addition to autologous units. Conclusion. Using measures of efficacy similar to those reported in studies of adults, autologous blood was found to be more effective in meeting the transfusion needs of pediatric patients who required posterior spinal fusion than in meeting those needs in adult surgical patients in previous studies.

Original languageBritish English
Pages (from-to)2735-2740
Number of pages6
JournalSpine
Volume22
Issue number23
DOIs
StatePublished - 1 Dec 1997

Keywords

  • Adolescent
  • Autologous
  • Blood
  • Blood loss
  • Pediatric
  • Posterior spinal fusion
  • Scoliosis

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