Risks associated with blood transfusion after total knee arthroplasty.
A retrospective study of 1,402 patients who underwent primary total knee arthroplasty (TKA) (1,194 unilateral, 208 bilateral) was performed. The strongest predictors for allogenic transfusion after surgery were advancing age (P<.001), low preoperative hemoglobin (P<.001), and the use of low-molecular-weight heparin postoperatively (P<.01). Pre-donation of 1 unit of autologous blood before TKA decreased the allogenic transfusion rate from a baseline of 38% to 11%, whereas pre-donating 2 units lowered the rate of breakthrough transfusion of allogenic blood to 7%. A patient with a preoperative hemoglobin >150 g/L or who is younger than age 65 with a preoperative hemoglobin >130 g/L may not benefit from pre-donation, and a high rate of wastage may result.
Bong
Matthew R
MR
NYU-Hospital for Joint Diseases, Department of Orthopaedic Surgery, New York, New York, USA.
Patel
Vipul
V
Chang
Eric
E
Issack
Paul S
PS
Hebert
Rudi
R
Di Cesare
Paul E
PE
D000367:Age Factors; D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001804:Blood Transfusion, Autologous / Q000706:statistics & numerical data*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D016015:Logistic Models; D008297:Male; D020370:Osteoarthritis, Knee / Q000601:surgery; D011182:Postoperative Care; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D065227:Transfusion Reaction
D006454:Hemoglobins; D006495:Heparin, Low-Molecular-Weight