Retrospective Study of Autologous Blood Transfusion for Patients with Jaw Deformities During the Past 5 Years in the Department of Oral and Maxillofacial Surgery at Tokyo Medical and Dental University (TMDU) Dental Hospital

Abstract

The advantage of autologous blood transfusion during orthognathic surgery is widely recognized in Japan. In the Department of Oral and Maxillofacial Surgery at Tokyo Medical and Dental University (TMDU) Dental Hospital, we have performed stored autologous blood transfusion (SAT) during orthognathic surgery since November 2006. In this study, we examined the patients who underwent orthognathic surgery with or without autologous blood transfusion. The subjects were 250 patients with jaw deformities who underwent orthognathic surgery in our department from 2008 to 2012. The results were as follows:
1. Between the group undergoing SAT and that without SAT, there were no significant differences in sex, age, height, weight, total blood volume and blood loss during operation.
2. In the group undergoing Le Fort I + Sagittal split ramus osteotomy, there was a high proportion of cases undergoing SAT, while there was a high proportion of cases without SAT in the group undergoing sagittal split ramus osteotomy.
3. The rates of decrease of red blood cell count, hematocrit value and hemoglobin value from pre-admission to post-operation showed no significant difference between the group undergoing SAT and that without SAT.
4. No case underwent SAT with homologous blood transfusion.
5. The largest number of accidents at the time of storing autologous blood was dysphoria.
6. The mean dose of SAT was 526.5 ± 194.8 mL.
In addition, we reviewed the Japanese literature (including this literature) to examine the current situation of autologous blood transfusion during orthognathic surgery in Japan. We found that SAT is used at all hospitals, but the amount of autologous blood transfusion during orthognathic surgery varied from hospital to hospital.
In conclusion, autologous blood transfusion during orthognathic surgery is useful to avoid homologous blood transfusion. However, it is desirable to produce guidelines on the amount of autologous blood transfusion during orthognathic surgery in Japan.