Autologous Blood Donation for Elective Surgery in Children Weighing 8–25 kg

Abstract

To determine whether autologous blood donation can be used safely and efficiently in children weighing 8-25 kg, we studied children whose perioperative blood losses were expected to exceed 25% of total blood volume. Blood donations were performed in pediatric units, under the direction of an anesthesiologist and a blood bank physician experienced in paediatric care. Twenty-four children, median age 6 years (1-13), were included. They underwent surgery mainly for digestive or urological disorders, and for orthopedic defects. Forty blood collections were performed of the 46 prescribed. Phlebotomies could not be performed in 1 child because of the mother's apprehension, and in 5 cases because of venous access problems. All phlebotomies were hemodynamically well tolerated. Hemodilution was also performed in 17 children, and cell saver used in 2. Allogeneic blood transfusion was avoided in 21/24 children.

Cell Saver: Is it beneficial in scoliosis surgery?

“…Previous studies have shown that Cell Saver does decrease the need for transfusions of other kinds [7][8][9][10]. Goulet et al [2] found that transfusion requirements were decreased when Cell Saver was used in orthopedic procedures.…”

The Efficacy of Predeposited Autologous Blood Transfusions in General Pediatric Surgery

“…The period between the collection and the operation was 1-2 weeks, and only 2 of these 13 patients required homologous blood transfusions in addition to PABT. Mayer et al 9 reported that 40 blood collections were performed in 24 children aged between 1 and 13 years old and weighing 8-25 kg, who underwent surgery for digestive, urological, or orthopedic disorders, and allogeneic blood transfusion was avoided in 21 children. Adzick et al 10 reported their experience with normovolemic hemodilution in 13 children aged between 5 months and 16 years, 10 of whom were younger than 5 years old, who underwent major tumor resections.…”

Autologous Blood Transfusion

“…In orthopedic surgeries wherein preoperative donation requires hematocrit to be in the upper 30s in order to donate, the hematocrit seldom decreases suf fi ciently to produce a hematopoietic response that will generate additional red blood cells. Therefore, it has been found that most patients who donate blood preoperatively are relatively anemic on the day of surgery and, as a result of their PABD, have an increased chance of requiring at least the transfusion of their autologous blood if not additional allogeneic blood [8][9][10][11] .…”