title: Effect of shed blood retransfusion on pulmonary perfusion after total knee arthroplasty: a prospective controlled study.
abstract: Postoperative shed blood retransfusion (autotransfusion) is a commonly used salvage method following major surgical operations, such as total knee arthroplasty (TKA). The systemic effects of shed blood are still unclear. We studied the effect of residual substances in the retransfused shed blood, on lung perfusion after TKA. Fifteen unilateral and one bilateral TKAs were performed with autotransfusion (the study group) and 15 unilateral and three bilateral TKAs were performed in a control group. Lung X-rays, arterial blood gases (ABG), D-dimer values, and lung perfusion scintigraphies were performed preoperatively and postoperatively. A mean of 300.0 +/- 335.6 ml of bank blood was needed in the autotransfusion group and a mean of 685.7 +/- 365.5 ml of bank blood was needed in the control group (p=0.001). There was a postoperative segmental perfusion defect at the lateral segment of the superior lobe of the left lung in one patient of the control group and he also had risk factors for thrombosis. Although both groups had a decrease in lung perfusion postoperatively, there were no significant differences among the groups regarding the lung perfusion scintigraphy, chest X-rays, ABG, and D-dimer values. In conclusion, although pulmonary perfusion diminishes following TKA, shed blood retransfusion does not add any risk to pulmonary perfusion.
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Afyon Kocatepe University, Afyon, Turkey. leventaltinel@aku.edy.tr
authors.forename: Levent
authors.initials: L
authors.lastname: Altinel
authors.forename: Eser
authors.initials: E
authors.lastname: Kaya
authors.forename: Kamil Cagri
authors.initials: KC
authors.lastname: Kose
authors.forename: Fatma
authors.initials: F
authors.lastname: Fidan
authors.forename: Volkan
authors.initials: V
authors.lastname: Ergan
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Fidan
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D001784:Blood Gas Analysis; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products; D006801:Humans; D008168:Lung / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010477:Perfusion / Q000379:methods*; D011183:Postoperative Complications / Q000503:physiopathology / Q000517:prevention & control*; D011446:Prospective Studies; D011652:Pulmonary Circulation / Q000502:physiology; D011655:Pulmonary Embolism / Q000503:physiopathology / Q000517:prevention & control*; D013902:Radiography, Thoracic; D011877:Radionuclide Imaging; D012307:Risk Factors
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D