Study Design. Retrospective observational study Objective. To clarify the efficacy of recombinant human erythropoietin-beta (EPO-beta) injections during autologous blood donation (ABD) before spinal deformity surgery in children and teenagers. Summary of Background Data. ABD is preferred for spinal deformity surgery. A few studies have assessed the usefulness of preoperative ABD with EPO-beta in anemic patients. Methods. Fifty-six spinal deformity surgery patients (41 females, 15 males; median age: 15 yrs; range, 5–19 yrs) underwent preoperative ABD. ABD was performed weekly according to the patient's body weight with a subcutaneous EPO-beta injection (24,000 U). The collected blood volumes were compared among the low hemoglobin (low-Hb) (<13 g/dL), mid-Hb (13–13.9 g/dL), and high-Hb (≥14 g/dL) groups using the Kruskal-Wallis test. The effects of EPO-beta injection on the Hb levels were estimated using a linear mixed model. Results. The patients underwent a median of four ABD collections (range, two to six). The median collected volume per ABD was 200 mL (range, 40–400 mL). The median total blood collection was 700 mL (range, 160–1,350 mL); the corresponding values were 700 mL, 700 mL, and 800 mL in the low-Hb, mid-Hb, and high-Hb groups, respectively ( P = 0.964). The median blood loss was 500 mL (range, 10–2,940 mL); 53 out of 55 patients (96%) did not require unplanned allogeneic transfusion, including 11 out of 12 (92%) cases with blood loss >1,000 mL. The additional recovery of Hb levels with one EPO-beta injection was 0.29 ± 0.14 g/dL ( P = 0.039) after adjusting for confounding factors. Conclusion. ABD with an EPO-beta injection is useful for avoiding allogeneic transfusion during spinal deformity surgery in children and teenagers, and patients in the low-Hb group achieved ABD volumes equivalent to those in the high-Hb group. Thus, an additional recovery of Hb levels of 0.29 g/dL per injection can be expected after 1 week. Level of Evidence: 4
An Internationl journal for the study of the spine – Wolters Kluwer Health
Published: Nov 1, 2015
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