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Wasting of preoperatively donated autologous blood in the surgical treatment of adolescent idiopathic scoliosis.

Bess RS, Lenke LG, Bridwell KH, Steger-May K, Hensley M

Washington University Medical Center, Department of Orthopaedic Surgery, St. Louis, MO, USA. shay.bess@hsc.utah.edu

STUDY DESIGN: Retrospective, case-control. OBJECTIVE: Evaluate the utility of preoperative autologous blood donation (PABD) for surgical treatment of adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: Recent data have highlighted overuse of PABD in elective surgery; however, PABD is a major blood conservation strategy for AIS surgery. METHODS: Medical records of 123 patients treated for AIS between June 1995 and November 2004 were reviewed. Patients were divided into PABD (n = 104) and nondonors (NPABD; n = 19). RESULTS: No differences existed between PABD and NPABD for age, major curve size, or operative procedures. Average PABD preoperative hematocrit was lower than NPABD (37.8 vs. 40.2; P < 0.005). PABD patients were 9 times more likely to be transfused than NPABD, and 3 times more likely to be transfused for each unit donated. There was a 25% transfusion risk reduction for each percent preoperative hematocrit increase. Minimum one autologous unit was not transfused in 32 patients (31%). Twenty-nine PABD patients (28%) were transfused for hematocrit >30. Fifty-three PABD patients (51%) wasted at least one unit or were transfused for hematocrit >30. CONCLUSIONS: The majority of PABD patients (51%) wasted minimum one autologous unit or were transfused at a high hematocrit (>30). More precise PABD guidelines are needed to limit unnecessary transfusion and wasted resources.

Published 20 September 2006 in Spine, 31(20): 2375-80.
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Blood Donation Research Today Archive:

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