159.
Transfusion of intra-operatively collected autologous blood in spinal
surgery. Is it safe?
Michael Rud Lassen
Spine Center Copenhagen Copenhagen University Hospital Glostrup
Background:
Spinal surgery is often associated with blood loss and need for
blood transfusions. Transfusion of allogenic blood introduces risks such as
transfusion reactions and disease transmission. An autologous, whole blood
transfusion alternative is the Sangvia system (Astra Tech AB, Sweden).
Purpose / Aim of Study:
To investigate safety of the Sangvia system when
used intra-operatively in spinal surgery.
Materials and Methods:
49
patients scheduled for spinal surgery were
included. Blood was collected using the Sangvia system and patients were
randomized to reinfusion of shed blood or no reinfusion. A maximum
reinfusion volume of 1500 ml was applied. The shed blood and venous blood
samples drawn before and after surgery were analyzed for plasma hemoglobin
(
p-Hb), hemoglobin, inflammatory mediators, potassium and creatinine.
Adverse events were also registered.
Findings / Results:
A mean volume of 490 ml was retransfused. The shed
blood had elevated levels of p-Hb (total mean 12.5 g/l) that resulted in
temporarily elevated serum concentrations of p-Hb after reinfusion. Potassium
in shed blood was also elevated (total mean 47 ìmol/l). The peak level of
systemic p-Hb reached 1.4 g/l at end of transfusion but normalization was
obtained within 24 hours. No impact was seen on systemic potassium or
creatinine levels. Reinfusion of autologous blood led to equal or lower increase
of pro- inflammatory mediators and higher post- operative hemoglobin levels.
Hematuria was reported in four patients after reinfusion but no other relevant
adverse events were reported.
Conclusions:
Reinfusion of shed blood collected during spinal surgery causes
a temporary increase in systemic concentrations of p-Hb without affecting
systemic potassium and creatinine levels or increasing risk for adverse events.
The results indicate that the Sangvia system is safe to use in spinal surgery.
