title: Autologous blood transfusion in total knee replacement surgery.
abstract: We compared allogeneic blood usage for two groups of patients undergoing total knee replacement surgery (TKR). Patients were randomized to receive either their post-operative wound drainage as an autotransfusion (n=115) after processing or to have this wound drainage discarded (n=116). Allogeneic blood was transfused in patients of either group whose haemoglobin fell below 9 g dl(-1). Only 7% of patients in the autotransfusion group required an allogeneic transfusion compared with 28% in the control group (P<0.001). There was no hospital mortality and only 3% mortality from all causes at the study completion, which spanned 6 months to 3 yr. There was a higher incidence of infection requiring intervention in the allogeneic group (P<0.036). Total patient costs were Pound Sterling 113 greater in the autotransfusion group. We conclude that in this type of surgery post-operative cell salvage is a safe and effective method for reducing allogeneic blood use.
authors.affiliation: Morriston Hospital, Swansea NHS Trust, UK.
authors.forename: D
authors.initials: D
authors.lastname: Thomas
authors.forename: K
authors.initials: K
authors.lastname: Wareham
authors.forename: D
authors.initials: D
authors.lastname: Cohen
authors.forename: H
authors.initials: H
authors.lastname: Hutchings
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000379:methods; D019645:Arthroplasty, Replacement, Knee; D001803:Blood Transfusion / Q000191:economics; D001804:Blood Transfusion, Autologous / Q000191:economics / Q000379:methods*; D005260:Female; D017048:Health Care Costs; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*
chemical_list: D006454:Hemoglobins