Efficacy and economics of postoperative blood salvage in patients undergoing elective total hip replacement.
BACKGROUND
Patients undergoing total hip replacement (THR) regularly receive allogenic blood transfusions. The infusion of allogenic blood exposes the recipient to significant risks including the transmission of infection, anaphylactic and haemolytic reactions. The purpose of this study was to determine the effect of introducing a system to retransfuse salvaged drainage blood in patients undergoing primary THR.


METHODS
We reviewed records of 109 consecutive patients who underwent THR following the introduction of the ABTrans autologous retransfusion system at our institution in January 2000. For comparison, we reviewed the medical records of 109 patients who underwent the same procedure immediately before the introduction of the retransfusion system.


RESULTS
Overall, 9% of patients treated with blood salvage and 30% treated without blood salvage required allogenic blood transfusions. Patients treated with the salvage system had significantly smaller haemoglobin drops in the peri-operative period (difference 0.56 g/dl; P = 0.001). The overall cost of using the retransfusion system was similar to that of routine vacuum drainage when the savings of reduced allogenic blood transfusion were taken into account.


CONCLUSIONS
The retransfusion of postoperative drainage blood is a simple, effective and safe way of providing autologous blood for patients undergoing primary THR.
Mirza
Saqeb B
SB
Department of Orthopaedics, Weston General Hospital, Weston-super-Mare, Somerset, UK. saqeb_mirza@yahoo.com
Campion
Jon
J
Dixon
John H
JH
Panesar
Sukhmeet S
SS
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000191:economics*; D001804:Blood Transfusion, Autologous / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D002985:Clinical Protocols; D017558:Elective Surgical Procedures / Q000191:economics; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D011182:Postoperative Care / Q000191:economics / Q000379:methods