Predeposit autologous donation in spinal surgery: a multicentre study.
BACKGROUND
Allogeneic blood transfusions (ABT) are often necessary in elective spine surgery because of perioperative blood loss. Preoperative autologous blood donation (PABD) has emerged as the principal means to avoid or reduce the need for ABT. Consequently, a multicentre study was conducted to determine the yield and efficacy of PABD in spine surgery and the possible role of recombinant human erythropoietin (EPO) in facilitating PABD.


METHODS
We retrospectively reviewed the hospital charts and blood bank records from all consecutive spine surgery patients who were referred for PABD. Data were obtained from two A-category hospital blood banks and one general hospital. Although we collected data from 1994, the analytic study period was from the last quarter of 1995 to December 2003. Fifty-four (7%) out of 763 patients referred for PABD were rejected, and medical records were available for 680 patients who were grouped into spinal fusion (556; 82%) and scoliosis surgery (124;18%). EPO was administered to 120 patients (17.6%). From 1999 to 2003, PABD steadily increased from 60 to 209 patients per year.


RESULTS
Overall, 92% of the patients were able to complete PABD, 71% were transfused, and almost 80% avoided ABT. PABD was more effective in fusions (86%) than in scoliosis (47%). Blood wastage was 38%, ranging from 18% for scoliosis to 42% for fusions. EPO allowed the results in the anaemic patients to be improved.


CONCLUSIONS
Therefore, despite the limitations of this retrospective study, we feel that PABD is an excellent alternative to ABT in spine surgery. However, the effectiveness of PABD may be enhanced if associated with other blood-saving techniques.
García-Erce
José A
JA
Department of Haematology and Haemotherapy, Hospital Universitario Miguel Servet, Paseo Isabel La Católica 1, 50009 Zaragoza, Spain. joseerce@vodafone.es.
Muñoz
Manuel
M
Bisbe
Elvira
E
Sáez
Montserrat
M
Solano
Víctor Manuel
VM
Beltrán
Sandra
S
Ruiz
Aina
A
Cuenca
Jorge
J
Vicente-Thomas
Javier
J
D000328:Adult; D001771:Blood Banks / Q000706:statistics & numerical data; D016063:Blood Loss, Surgical; D017558:Elective Surgical Procedures; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery; D013123:Spinal Fusion; D013131:Spine / Q000601:surgery*; D014182:Transplantation, Autologous / Q000379:methods / Q000706:statistics & numerical data* / Q000639:trends; D014184:Transplantation, Homologous / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome
D011994:Recombinant Proteins; D004921:Erythropoietin