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Spine

REDUCING ALLOGENIC BLOOD TRANSFUSIONS IN SPINAL SURGERY

Britspine, British Scoliosis Society (BSS), Society for Back Pain Research (SBPR), British Association of Spine Surgeons (BASS)



Abstract

Surgery of the spine is associated with blood loss and frequently transfusion, with consequent risk of infection and reactions. It also costly, and puts a strain on national blood banks.

A new blood salvage device works by ‘washing’ and centrifuging the blood lost during surgery; which can then be re-transfused into the patient.

In a retrospective study 46 consecutive spinal surgeries with Cell Saver were compared with 39 matched surgeries without. Blood loss and units transfused was obtained from the transfusion database and the anaesthetic record.

Average blood loss in the Cell saver group was 1382ml compared to 1405ml in the pre-Cell Saver group.

Average allogenic transfusion was 1.30 units with cell saver compared to 2.78 units without. An average 2.3 units of lost blood were re-infused in the Cell Saver group.

26 (57%) of the Cell Saver group require no allogenic blood at all, whereas only 10 (26%) of patients in the pre-Cell Saver group had no transfusions.

One unit of blood costs £130.52, and the Cell saver device costs £100 per patient. The average cost per patient in the Cell saver group was £270 (any transfusion plus cost of Cell Saver), compared to an average of £368.50 in the pre-Cell Saver group: a saving of £92.50.

The Cell Saver decreased blood transfusions by 46% per patient and by 40% overall, a saving of £92.50 per patient. The number of patients receiving no allogenic blood increased by 31%.