A comparison of pre-operative autologous and homologous transfusions in patients undergoing elective maxillofacial surgery

Background: Autologous blood transfusion is a proven method of blood conservation in elective surgical procedures. Moreover due to increasing concerns about the transmission of blood borne diseases through homologous blood transfusion, autologous blood donation has now become more popular among the patients. This study was conducted at the Department of Oral and Maxillofacial Surgery, Government Dental College, Kozhikode, Kerala, India to assess the feasibility of autologous transfusion in elective maxillofacial surgeries. Objectives: This study was designed to compare the efficacy of pre-operative autologous and homologous transfusions in restoring the blood parameters such as hemoglobin, hematocrit and platelet count in patients undergoing elective maxillofacial surgeries and to compare the post operative complications associated with both type of transfusions. Methods: Fifteen patients reported at the Department of Oral and Maxillofacial Surgery, Government Dental College, Kozhikode from March 2012 to September 2013 for elective surgical procedures were selected as the study group. Fifteen control patients reported during the same period were selected, who received homologous blood transfusion during surgery. The hemoglobin level, hematocrit and platelet count were measured pre-operatively and on 1st and 7th post-operative days. The present study assessed the mean change in hemoglobin, hematocrit and platelet count from the baseline values at two points of time: first post-operative day and one week following surgery. After the blood transfusion, temperature was also monitored and all the post-operative complications were registered in both groups of patients. Results: This study showed that there was no significant difference in the ability of two types of transfusions in restoring the pre-operative hemoglobin on the first and seventh post-operative days. Although the reduction in hematocrit was comparatively lesser in the study group, no statistically significant difference was observed between the two groups on the seventh post-operative day. The increase in platelet count was comparatively more in control group on the first and seventh post-operative days. It was also noted that none of the patients in the study group encountered any complications either during donation or after transfusion. But three patients in control group developed febrile reactions during the post-operative period. Conclusion: Autologous blood donation by using pre-operative autologous blood donation is a safe, simple and easy procedure, in elective maxillofacial surgical procedures with anticipated high intra-operative blood loss and in which blood transfusion is likely. Although pre-operative autologous blood donation reduces, it does not totally eliminate the need for homologous transfusion for elective maxillofacial surgery.