Retrospective analysis of autologous blood use in bimaxillary repositioning osteotomy surgery: a quality improvement study

• Published in: Transfusion (Philadelphia, Pa.) Pa.), 2009-08, Vol.49 (8), p.1747-1753
• Main Authors: Böttger, Sebastian, Streckbein, Philipp, Hartmann, Bernd, Schaaf, Heidrun, Howaldt, Hans Peter, Junger, Axel
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Donors; Blood Loss, Surgical - prevention & control; Blood Transfusion, Autologous - methods; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Body Weight; Female; Germany; Hematocrit; Humans; Male; Medical sciences; Middle Aged; Orthognathic Surgical Procedures; Quality Control; Retrospective Studies; Sex Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/j.1537-2995.2009.02169.x

BACKGROUND: Multiple studies have considered the necessity of preoperative autologous blood donation before bimaxillary orthognathic osteotomies. In the context of a quality improvement project, this topic was also investigated in our institution. Furthermore, the transfusion practice was analyzed and the correlations between patient, operative variables, and blood loss were studied. STUDY DESIGN AND METHODS: In accordance with the recommendations of the Federal Medical Association and the Federal Ministry for Health and Social Security, a transfusion demand list was compiled using data of 82 patients who underwent bimaxillary orthognathic surgery between 1997 and 2005. The maximum blood loss tolerable without transfusion (MBL) was calculated for each patient on the basis of sex, weight, height, and preoperative hematocrit (Hct). This was compared with the actual transfusion and blood loss data. RESULTS: An autologous blood donation was carried out in 65 of 82 patients (79.3%). Sixty‐two of 65 autologous blood donors (95.4%) and 2 of 17 patients (11.8%) without autologous blood donation received transfusion. The actual blood loss did not exceed the calculated MBL in 48 of the 82 cases. Nevertheless, 31 of these 48 patients (64.6%) received transfusions. For patients with a low calculated MBL, only a trend to a higher transfusion rate was observed, although the actual blood loss in these cases more often exceeded the individually calculated MBL (p