title: Pre-operative autologous blood donation versus no blood donation in total knee arthroplasty: a prospective randomised trial.
abstract: OBJECTIVE
  During total knee arthroplasty (TKA) blood loss can be significant and in spite of all techniques for reducing blood loss there is still a significant possibility for blood transfusions. For blood loss management during TKA, pre-operative autologous blood donation (PABD) is still a standard of care. In this prospective randomised study we have evaluated the efficacy of PABD in patients undergoing TKA to answer the question whether there is any need for autologous blood donations during TKA and, if yes, for which group of patients.
  
  
  METHODS
  Patients were randomised to three groups. In group 1 patients did not donate autologous blood, in group 2 patients donated 1 dose 72 hours prior to TKA and in group 3 patients donated autologous blood 14 days prior to TKA. In all patients haemoglobin, haematocrit, thrombocyte and reticulocyte values, iron concentrations (Fe, unsaturated iron binding capacity, total iron binding capacity), activated partial thromboplastin time, prothrombin time, and intra-operative and post-operative blood loss were measured and compared.
  
  
  RESULTS
  With PABD there was no reduction in allogeneic blood transfusions and a large number of taken doses of autologous blood was discarded, which significantly increased the cost of treatment for these patients. For patients undergoing TKA, PABD can provoke iatrogenic anaemia and thereby increase the likelihood of the need for allogeneic blood transfusion.
  
  
  CONCLUSIONS
  Results of our study showed that PABD in non-anaemic patients is not justified and is not economically feasible.
authors.affiliation: Unit of Anesthesia and Intensive Care, Department of Orthopaedic Surgery, Clinical Hospital Centre Zagreb, Zagreb, Croatia.
authors.forename: Sanja
authors.initials: S
authors.lastname: Jakovina Blazekovic
authors.forename: Goran
authors.initials: G
authors.lastname: Bicanic
authors.forename: Pero
authors.initials: P
authors.lastname: Hrabac
authors.forename: Branko
authors.initials: B
authors.lastname: Tripkovic
authors.forename: Domagoj
authors.initials: D
authors.lastname: Delimar
mesh_terms: D000368:Aged; D000740:Anemia / Q000453:epidemiology; D019645:Arthroplasty, Replacement, Knee; D001782:Blood Donors; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous / Q000191:economics / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000191:economics / Q000379:methods*; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome