Allogeneic Transfusion after Predonation of Blood for Elective Spine Surgery

• Published in: Clinical orthopaedics and related research Vol. 466; no. 8; pp. 1949 - 1953
• Main Authors: Brookfield, Kathleen F., Brown, Mark D., Henriques, Steven M., Buttacavoli, Frank A., Seitz, Alison P.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.08.2008; Springer; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Biological and medical sciences; Blood Loss, Surgical - statistics & numerical data; Blood Transfusion, Autologous - statistics & numerical data; Conservative Orthopedics; Diseases of the osteoarticular system; Elective Surgical Procedures; Female; Humans; Intraoperative Period; Laminectomy; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Original; Original Article; Orthopedics; Retrospective Studies; Spinal Fusion; Sports Medicine; Surgery; Surgical Orthopedics; Degenerative Spondylolisthesis; Autologous Blood; Blood Replacement; Allogeneic Transfusion; Allogeneic Blood Transfusion; Treatment; Transfusion; Spine; Surgery; Orthopedics; Elective; Blood
• ISSN: 0009-921X; 1528-1132
• DOI: 10.1007/s11999-008-0306-4

The literature suggests preoperative autologous blood donation in total joint arthroplasty is associated with increased overall transfusion rates compared with nondonation and is not cost-effective for all patients. We asked whether the amount of intraoperative blood loss and blood replacement differs between autologous donors and nondonors in elective spine surgery and whether the rates of allogeneic blood transfusions differ between the two groups; we then determined the cost of wasted predonated units. We retrospectively reviewed 676 patients who underwent elective lumbar spine surgery and compared relevant data to that in a matched cohort of 51 patients who predonated blood and 51 patients who received only cell-saver blood and underwent instrumented spinal fusion. Patients who predonated blood had similar blood loss as patients who did not predonate, but they had more blood replacement (1391 cc compared with 410 cc). Patients who predonated blood also had a lower preoperative hemoglobin level and wasted a half unit of blood on average. There was no major difference in allogeneic blood transfusion rates between the two groups. Our data suggest for short, instrumented lumbar fusion surgeries in patients with a normal coagulation profile, preoperative blood donation is not beneficial. Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.