title: The utility of the perioperative autologous transfusion system OrthoPAT in total hip replacement surgery: a prospective study.
abstract: BACKGROUND
  Total hip replacement (THR) is associated with a significant perioperative blood loss, and 30-50% of these patients receive allogeneic blood transfusion (ABT). We evaluated the clinical utility of washed shed blood (WSB) return to reduce ABT in THR patients.
  
  
  METHODS
  Data from 108 consecutive THR patients were prospectively collected. WSB salvage and reinfusion (OrthoPAT) was intended for 60 (Reinfusion group), whereas the remaining 48 patients served as control group. Patients received ABT if haemoglobin <8 g/dl or clinical signs and symptoms of acute anemia.
  
  
  RESULTS
  WSB return was possible in 49 patients (205 +/- 151 ml of erythrocyte/patient), without any clinically relevant incident. Return of WSB decreased both the ABT rate (48 vs. 15%, for control and reinfusion groups, respectively; P = 0.001) and the ABT index (371 +/- 154 ml RBC vs. 53 +/- 117 ml RBC, respectively; P = 0.001), without differences between cemented and uncemented THR. In addition, patients from reinfusion group showed a trend to lower postoperative infection rate (10 vs. 2%, respectively; P = 0.086).
  
  
  CONCLUSIONS
  Perioperative salvage and return of WSB in THR seems to effectively reduce the requirements for ABT. However, for patients with preoperative Hb < 13 g/dl, some additional blood saving method should be associated to WSB return.
authors.affiliation: Regional Blood Centre, Jaén, Spain.
authors.forename: María Monte
authors.initials: MM
authors.lastname: del Trujillo
authors.forename: Antonio
authors.initials: A
authors.lastname: Carrero
authors.forename: Manuel
authors.initials: M
authors.lastname: Muñoz
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000628:therapy*; D011446:Prospective Studies