RESUMEN
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) (<13âg/dL), mid-Hb (13-13.9âg/dL), and high-Hb (≥14âg/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 200âmL (range, 40-400âmL). The median total blood collection was 700âmL (range, 160-1,350âmL); the corresponding values were 700âmL, 700âmL, and 800âmL in the low-Hb, mid-Hb, and high-Hb groups, respectively (Pâ=â0.964). The median blood loss was 500âmL (range, 10-2,940âmL); 53 out of 55 patients (96%) did not require unplanned allogeneic transfusion, including 11 out of 12 (92%) cases with blood loss >1,000âmL. The additional recovery of Hb levels with one EPO-beta injection was 0.29â±â0.14âg/dL (Pâ=â0.039) 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 0.29âg/dL per injection can be expected after 1 week. LEVEL OF EVIDENCE: 4.