Autotransfusions in scoliosis surgery. Review of 20 Harrington fusions.
A significant blood loss during a Harrington fusion for scoliosis is usually replaced with homologous bank blood transfusion. To decrease the risk of potential severe complications for the patient, autotransfusions were used in 20 patients undergoing posterior spinal fusions for scoliosis. To have fresh blood at the time of surgery the previous stock was recirculated at each weekly session. The last of the 3 sessions was one week before surgery. The mean age was 17 years and 4 months. On average the hemoglobin before donation was 12.85 g, the volume donated 1455 ml, and the hemoglobin preoperatively 12.04 g. Blood loss averaged 1175.0 ml at surgery and 635.0 ml subsequently by vacuum drainage. Two days after operation the hemoglobin averaged 10.4 g. No complications related to transfusion occurred. Three patients received additional homologous blood. The rationale, modes, technique, value, and underutilization of autotransfusion are noteworthy.