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Autologous Blood Donation Tied to Pre-Op Anemia, Blood Loss

Pre-op blood donation increases likelihood of transfusion within first 24 hours of surgery

WEDNESDAY, Dec. 14 (HealthDay News) -- Preoperative autologous blood donation (PABD) during posterior lumbar spinal surgery is associated with preoperative anemia and a lower transfusion threshold than allogeneic blood use, according to a study published in the Dec. 15 issue of Spine.

Cian Kennedy, M.B., B.Ch., from Weill Medical College of Cornell University in New York City, and colleagues investigated the transfusion patterns associated with PABD during posterior lumbar spinal surgery. Data were collected from medical records of 413 donors (PABD), and 128 nondonors (non-PABD [NPABD]) treated for spinal stenosis between January 1997 and February 2000.

The investigators found that the average preoperative hemoglobin (Hb) was 0.62 units higher in the NPABD than the PABD groups. In PABD patients, preoperative Hb was negatively associated with the number of units donated. Compared with NPABD patients, PABD patients who donated one and two units of blood were 7.5 and 9 times more likely to be transfused within the first 24 hours, respectively. Compared to PABD patients who donated at least two units of blood, allogeneic blood transfusion was 25 times more likely to be required by NPABD patients. Perioperative blood loss was significantly and independently predicted by autologous donation. Compared with NPABD patients, patients who donated at least two units of blood lost about 1.3 more units of Hb. Compared with PABD patients who had a decompression with instrumented fusion, those PABD patients who had a decompression with noninstrumented fusion had an 8.64-fold increased odds of wastage.

"Autologous blood donation induced preoperative anemia and resulted in a lower transfusion threshold when compared with allogeneic blood usage," the authors write.

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