Toward the elimination of homologous blood use in elective lumbar spine surgery

Dana G. Seltzer, Mark D. Brown, Janet S. Tompkins, Isadore Enger, Frank P. Cammisa

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Two hundred twenty-four consecutive patients underwent elective posterior lumbar spinal surgery over a 3 1/2 -year span at the University of Miami/Jackson Memorial Medical Center. Patients ranged in age from 17 to 87 years, and 58% were male. Fifty-eight patients underwent revision surgery, and 65 patients required fusions, including 35 necessitating internal fixation. One hundred seventy-four patients (78%) were requested to participate in a preoperatively donated autologous blood (PDAB) program. Six of these patients were excluded from participation, and 168 patients banked 425 U of autologous blood. Eighty percent of the patients participating in the PDAB program received some or all of their donated blood. Intraoperative blood salvage was used in 37% of cases. Seven patients received homologous blood: four in addition to salvaged and donated blood, two that were unable to donate blood due to positive hepatitis B serology, and one erroneously. The combined use of PDAB and intraoperative salvage program allowed autologous blood replacement to meet the total transfusion requirements of 96% of the patients who predeposited blood, including 94% of those undergoing spinal fusions. Autologous blood comprised 99% of the total blood replacement used in this series, and 95% of the patients requiring blood transfusions received only autologous blood. Establishment of a protocol judiciously using PDAB in conjunction with intraoperative blood salvage can result in virtual elimination of the need for homologous blood transfusion in elective lumbar spine surgery.

Original languageEnglish (US)
Pages (from-to)412-421
Number of pages10
JournalJournal of Spinal Disorders
Volume6
Issue number5
DOIs
StatePublished - Oct 1993

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Keywords

  • Homologous blood
  • Lumbar spine surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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