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This one is about: Storing Blood for Surgery?

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A parent writes:

The time for my son's cleft palate surgery is finally here. I'm very nervous about it and anxious to get it over with. The surgeon said we could store blood for his surgery but says it really isn't necessary. I'd like to hear what other people did. How many people stored blood for their child's
surgery. Why would it even be necessary to have a blood transfusion if something went wrong with a cleft palate surgery?  We're just wondering if we are going overboard with being cautious or if it really is something we should do - especially since the surgeon said it really isn't necessary. Thanks everyone!

RESPONSES:

Hi --- There really is not much bleeding involved with palate repair.... none of mine ever had to have a transfusion -- and Jacob even hemorrhaged after the repair... still no need for transfusion. I also know of no child who has had to have a blood transfusion for palate surgery -- I am sure that very extreme complications could come into play, but basically, the probability of needing this sort of transfusion are infinitesimally small.

Joanne
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Note: This post was written a while back but still pertains to this subject

It is extremely rare for a child to need blood transfusions in ANY cleft-related surgery. They have techniques for reducing blood flow during surgery, and there just is not that much lost. During Jacob's palate repair he even hemorrhaged, but he did not need a transfusion. That does not mean that there NEVER is a need for blood transfusion - - I think, didn't Geoffrey need one for his bone graft? Jacob did not, and the bone graft incisions now are so much smaller than before that I cannot imagine them needing one even for that. Some doctors will have you bank blood if they think there is even a remote chance you may need it - - but in the overwhelming majority of cases - almost to the point of saying in ALL cases (except for the occasional exception) there is no need for blood transfusion.

Joanne

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In the year and a half or so I've been on CT, there have been only 2-3 people, out of hundreds, that we've heard about who've had hemorrhaging that required transfusion after surgery -- it is that rare, I was surprised to find. But, back in 1969, after palate surgery at 9 mo., I was one of those people. It was totally unexpected, and happened after we had already left the hospital after a few days' stay... Very strange, really...an emergency surgery and a transfusion saved my life. So, while very rare it's not unheard-of.

Plus, having had most of my surgery in Houston in the mid- to late-80's, back when the blood supply was much less safe than it is now, I was always required to do autologous donation as part of my surgeon's general policy. These days, the blood supply is much safer, and HIV is much less a threat than the hepatitis's (which, actually, can be fatal as well). But my thought is, once you're exposed to one of those blood-borne pathogens, there is no going back . . . no second chance to make another decision. So if even the smallest odds of a problem can be avoided . . . Plus, I think that besides the blood borne pathogens, there are sometimes cross-reactions that can happen -- allergic things, that  kind of thing . . . those are harder to prevent with testing beforehand. Autologous donorship eliminates those problems altogether.

Maybe I notice it more than other people do, since I always check "yes" in answer to the question, but IF your child should need a transfusion, on just about every medical form they will fill out for the rest of their lives, they'll be asked "Have you ever had a blood transfusion? If so, when?" If they're able to say, "yes, but it was autologous," then the questions stop there, and it's a non-issue. If not, then there is a question mark, some uncertainty -- you'll be asked "Has there been follow-up testing, etc etc?" that sort of thing.  I don't know what the exact protocol is for people who've had transfusions, but to me, it's just better to avoid the issue entirely if at all possible (even though chances are the donated blood will never need to be used).

Not fun, I guess, to watch your baby donate blood s/he will probably never need, but I do fall into the "better safe than sorry" camp on this one, at least.

My .02,
Lark


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