Anesthetic Management of Healthy Donor for Bone Marrow Harvesting

Hong, Sung Jin; Yoo, Joo Hyun

Abstract

BACKGROUND: Bone marrow transplantation is increasingly common as a therapeutic modality. Large volume of bone marrow has been aspirated under general anesthesia and can cause hemodynamic instability and complications. The purpose of this study is to review the cases of bone marrow harvesting in healthy donors and to find the proper anesthetic management for this procedure.
METHODS
We retrospectively analyzed the medical records of 479 cases of bone marrow harvesting in healthy donor performed in Catholic University of Korea, St. Mary's hospital.
RESULTS
Mean harvest volume was 1097.2 120.6 ml and duration of aspiration was 53.8 22.6 minutes. Aspirated harvesting volume was mainly replaced by blood products and crystalloid solutions. 55.7% of donors received homologous blood products and 74.5% of donors received autologous blood during the perioperative period. Mean hemoglobin concentration before harvesting was 12.3 1.8 gm/dL and there was no significant changes in hemoglobin concentrations after harvesting. The incidence of hypotension and tachycardia was 22.3 and 20.5%, respectively with higher incidence in the female group (p<0.05). The incidence of febrile reaction after harvesting was 15.5%. Average duration of admission for harvesting was 3.5 0.9 days and there were no life-threatening complications.
CONCLUSION
We conclude that 479 cases of bone marrow harvesting were performed safely but we should consider to reduce the volume of homologous transfusion in healthy donors.