[Postoperative autologous retransfusion of collected shed blood after total knee arthroplasty with the cell saver].
OBJECTIVE
The purpose of this study was to examine if it is possible to reduce transfusion of blood units by collecting shed blood with the Cell Saver for autologous retransfusion in total knee arthroplasty (TKA).


METHODS
In 186 patients drainage blood was collected over a 6-h period after total knee arthroplasty with a Cell Saver system in order to make retransfusions if necessary. A tourniquet was used routinely throughout the operation. No preoperative blood donation was performed. In 19 patients preoperative haemoglobin levels were below 12 g/dL (group A, anaemic patients). In the other 167 patients (group B) the preoperative haemoglobin levels were higher.


RESULTS
4 patients (21 %) in group A received a homologous blood transfusion. Only 1 patient (0.6 %) in group B received one unit of erythrocyte concentrate (difference statistically significant, P < 0.001). In group A 8 patients (42 %) received 284 ml (145-621 ml) Cell-Saver concentrate on average, 38 patients (23 %) in group B received 358 mL (147-776 ml) Cell-Saver concentrate on average.


CONCLUSIONS
With a risk lower than 1 % for patients without anaemia to get a homologous blood transfusion one can do without the more expensive preoperative blood donation in total knee arthroplasty if a tourniquet is used for the operation and a Cell Saver is used for facultative retransfusion of drainage blood.
Orthopädische Klinik für die Universität Regensburg, Asklepios Klinikum Bad Abbach. m.handel@asklepios.com
M
M
Handel
D
D
Boluki
O
O
Loibl
J
J
Schaumburger
T
T
Kalteis
J
J
Matussek
J
J
Grifka
D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical / Q000503:physiopathology*; D001793:Blood Preservation; D001804:Blood Transfusion, Autologous / Q000379:methods*; D017707:Erythrocyte Transfusion; D005260:Female; D006452:Hemoglobinometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D019106:Postoperative Hemorrhage / Q000097:blood / Q000628:therapy*