Is there a need for autogenous blood donation in orthognathic surgery?
BACKGROUND
The present study sought to determine the frequency of blood transfusion and to evaluate the need for autogenous blood donations in patients undergoing bimaxillary orthognathic surgery.


METHODS
According to an inclusion and exclusion protocol, 65 patients were selected for further analysis. Twenty-six patients donated a total of 45 units of autogenous blood; the remaining 39 patients did not. Medical records were reviewed retrospectively.


RESULTS
Donors tended to have lower preoperative, intraoperative, and postoperative hemoglobin values, as well as lower hematocrit and leukocyte counts. Only the difference in mean preoperative leukocyte count, however, was statistically significant (donor: 6500/microl versus nondonor: 7400/microl; p = 0.021). The rate of transfusion was 2.5 percent for nondonors and 13 percent for donors of autogenous blood. Six donors had to be transfused a total of 8 units of autogenous blood, whereas only one of 39 nondonors received an allogenic blood transfusion. This difference turned out to be significant according to Fisher's exact test (p = 0.013). None of the donors received allogenic blood transfusion.


CONCLUSIONS
In the authors' analysis, preoperative autogenous blood donation appears to be effective in reducing exposure to allogenic blood. Donors of autogenous blood, however, were transfused significantly more often than nondonors were. Neither intraoperative blood loss nor hematological values justify a preoperative donation of autogenous blood on a regular basis.
Kessler
Peter
P
Department of Oral and Maxillofacial Surgery, The Institute for Medical Informatics, Biometry, and Epidemiology, University of Erlangen-Nuremberg, Erlangen, Germany. peter.kessler@mkg.imed.uni-erlangen.de
Hegewald
Janice
J
Adler
Werner
W
Zimmermann
Robert
R
Nkenke
Emeka
E
Neukam
Friedrich Wilhelm
FW
Fenner
Matthias
M
D000328:Adult; D001804:Blood Transfusion, Autologous / Q000706:statistics & numerical data*; D005260:Female; D006400:Hematocrit; D006801:Humans; D007958:Leukocyte Count; D016015:Logistic Models; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D019340:Osteotomy, Le Fort; D018579:Patient Selection; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000601:surgery