AUTHOR=Xu Xiao-Ping , Que Wen-Jun , Yu Ze-Bo , Shen Jie-Liang , Hu Zhen-Ming , Yang Xiao-Liang , Hao Jie 

TITLE=Clinical application of a modified predeposit autologous red blood cell apheresis in multistage spinal fusion: a single-center retrospective study

JOURNAL=Frontiers in Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1149093

DOI=10.3389/fmed.2023.1149093

ISSN=2296-858X

ABSTRACT=<sec><title>Purpose</title><p>This study aimed to evaluate the efficacy and safety of predeposit autologous RBC apheresis (PARA) in patients undergoing multilevel spinal fusion surgery.</p></sec><sec><title>Methods</title><p>A total of 112 patients from January 2020 to June 2022 were divided into two groups according to PARA: the PARA group (<italic>n</italic> = 51) and the control group (<italic>n</italic> = 61). The baseline characteristics of the patients, outcomes, transfusion cost, hospitalization cost, length of stay, complications, and changes in hemoglobin and hematocrit levels between the two groups were compared.</p></sec><sec><title>Results</title><p>The baseline characteristics were similar in both groups. No significant differences were found in functional outcomes, including VAS score (<italic>p</italic> = 0.159), ODI score (<italic>p</italic> = 0.214), JOA score (<italic>p</italic> = 0.752), and SF-36 score (<italic>p</italic> = 0.188) between the PARA and control groups. The amount and rate of intraoperative and perioperative allogeneic RBC transfusion were significantly higher in the control group than in the PARA group (<italic>p</italic> &lt; 0.001). The postoperative (9.04 ± 3.21 vs. 11.05 ± 3.84, <italic>p</italic> = 0.004) and total length of stay (15.78 ± 3.79 vs. 17.36 ± 4.08, <italic>p</italic> = 0.038) in the PARA group were significantly lower than those in the control group, respectively. Despite no difference in hospitalization cost (<italic>p</italic> = 0.737), the total blood transfusion cost in the PARA group was significantly lower, compared with the control group (<italic>p</italic> &lt; 0.001). For safety evaluation, there were no significant differences in Hb and Hct levels between the two groups at admission, on postoperative day 1, and postoperative day 3, respectively (<italic>p</italic> &gt; 0.05). Moreover, the number of postoperative infections in the PARA group was significantly lower than that in the control group (<italic>p</italic> = 0.038).</p></sec><sec><title>Conclusion</title><p>PARA was a novel, safe, and highly efficient technique for mass autologous blood preparation in a quite short preparation time. This method could significantly reduce the amount of allogeneic blood transfusion and length of stay, which could provide a theoretical basis for following clinical practice about the technique.</p></sec>