Association of intraoperative cell salvage combined with standard allogeneic transfusion with hematological parameters and clinical outcomes in pediatric tracheoplasty: a non-randomized cohort study.

OBJECTIVE: To investigate associations of intraoperative autologous blood salvage (IOCS) combined with allogeneic transfusion vs. allogeneic transfusion alone in pediatric slide tracheoplasty (STP) for congenital tracheal stenosis (CTS), regarding hematological parameters, coagulation function, clinical outcomes, and safety. METHODS: From October 2023 to February 2025, 69 children meeting inclusion criteria were enrolled in this non-randomized study. Based on parental consent for IOCS, 35 were allocated to the observation group (IOCS + allogeneic transfusion) and 34 to the control group (allogeneic transfusion alone). Pre- and postoperative hematological and coagulation parameters, allogeneic transfusion volume, adverse reactions, postoperative fever, hospital stay, and 6-month mortality were compared. RESULTS: Preoperative indicators showed no significant intergroup differences (P > 0.05). Postoperatively, the observation group had higher red blood cell count, hematocrit, and hemoglobin (all P < 0.05); shorter prothrombin time and higher fibrinogen (both P < 0.05); and no significant differences in APTT or TT (both P > 0.05). Intraoperative allogeneic red blood cell and fresh frozen plasma volumes were significantly lower in the observation group (both P < 0.05). No hemolytic or allergic transfusion reactions occurred. Postoperative fever was higher in the control group (P < 0.05), and hospital stay was shorter in the observation group (P < 0.05). No deaths occurred within 6 months. CONCLUSION: IOCS combined with allogeneic transfusion was associated with better postoperative hematological and coagulation profiles, reduced allogeneic blood requirements, and shorter hospital stay. No transfusion-related adverse reactions or deaths were observed. These findings warrant confirmation in prospective randomized studies.