Comparative analysis of the benefits of autotransfusion of blood by a shed blood collector after total knee replacement.
BACKGROUND
Joint replacement is associated with massive blood loss. Various techniques have been used to avoid the use of allogeneic blood. One of the techniques used is postoperative salvage and reinfusion of shed blood that was found to reduce the use of banked blood with its potential risk.


METHODS
We prospectively studied 365 patients who underwent knee joint replacement (TKR) and were divided in two groups. Group A's shed blood (SureTrans System) was collected ( n=194) and reinfused and group B's was not ( n=171, "controls"). Hemoglobin levels before and after the operation were recorded.


RESULTS
Allogeneic blood requirement for TKR decreased by 65% in group A compared to group B. The packed cell/patient index dropped from 0.91 to 0.29 in group 2A. Statistical analysis yielded the odds ratio for blood replacement, a "predicting formula" for blood replacement depending on hemoglobin levels, and a cutoff point for a patient's receiving blood replacement.


CONCLUSIONS
We recommend using this system in TKR for decreasing allogeneic blood replacement and potential associated risks. The predicting formula for blood replacement may be a helpful tool when making a decision of whether or not to use the collector system and for whom.
Steinberg
Ely L
EL
Department of Orthopaedic Surgery "B", Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, 64239, Tel-Aviv, Israel. eli_st@netvision.net.il
Ben-Galim
Peleg
P
Yaniv
Yona
Y
Dekel
Shmuel
S
Menahem
Aharon
A
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D001781:Blood Component Removal; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000379:methods*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016012:Poisson Distribution; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity
D006454:Hemoglobins