The replacement of a substantial amount of lost blood are frequently necessitated for spine surgery. The adverse effects of homologous transfusion such as, transmission of disease, isoimmunization, and hemolytic, febrile, anaphylactic reactions, have been well documented. The main purpose for the use of autologous transfusion is to prevent or decrease the adverse reaction of homologous transfusion, and there are different methods of autotransfusion such as, preoperative banked blood, acute preoperative hemodilution, hypotensive anesthesia, intraoperative and postoperative salvage of shed blood.
Authors have attempted to reduce the amount of homologous transfusion by intraoperative autotransfuser, ´Cell Saver Plus´. To evaluate the efficacy of intraoperative blood salvage, 120 patients who underwent spine surgery from February, 1994 to March, 1996, were included in one of two groups:Group I consisted of who recieved autologous transfusion, group Ⅱ who did not. group Ⅰ consisted of 66 patients and 54 patients consisted of group Ⅱ. The average age was 53 years in groupⅠand 55 years in group Ⅱ. In groupⅠ, preoperative diagnosis were 26 spinal stenosis, 12 spondylolisthesis, 19 kyphosis, and 9 scoliosis, and in groupⅡ, 38 spinal stenosis and 16 spondylolisthesis.
The average homologous transfusion volume was 1098 ㎖ in groupⅠand 1920 in group Ⅱ, the average gain of the homologous blood volume was 822 ㎖(42.8%). Hematologic findings such as, hemoglobin, hematocrit and serum potassium level showed no difference statistically in both groups. Complications by autotransfusion did not observe in groupⅠ. The surgery of the shorter segments had more possibility to be performed with only autologous transfusion. The efficacy of autologous transfusion was increased as a result of the larger amount of autologous transfusion collected in the surgery of the longer segments. It means that the efficacy of intraoperative autotransfusion is high in more extensive procedure. In the abscence of infection or malignancies, the use of intraoperative autologous transfusion is safe and effective method to prevent complications of homologous transfusion.
|