title: Effectiveness of an autologous transfusion system following cemented and non-cemented revisions of total hip arthroplasty.
abstract: OBJECTIVE
  The goal of this study was to analyse the efficacy of blood autotransfusion using a continuous autologous transfusion system in revisions of total hip arthroplasty (THA). We looked at whether administration of allogeneic blood units was reduced in these cases and if there is a difference between cemented and non-cemented revisions.
  
  
  METHODS
  Between January 2011 and December 2011, patients being treated with revision THA were included (n = 411). The following parameters were analysed: patient age, gender, weight (kg), height (cm), body mass index (BMI, kg/m(2)), surgical diagnosis, treatment and American Society of Anesthesiologists (ASA) classification score. The difference between pre- and post-operative haemoglobin (Hb, g/dl), amount of peri-operative blood loss (ml), amount of retransfused washed shed blood and amount of allogeneic and/or autologous transfusion (ml) were recorded.
  
  
  RESULTS
  In both the cemented and non-cemented revision THA groups, there was no significant difference between pre- and post-operative Hb with or without using an autotransfusion system. In 92 of 186 cemented cases using an autologous transfusion system (49.5%) and 38 of 117 non-cemented cases using an autologous transfusion system (32.5%), allogeneic blood transfusion (ABT) was required. Cemented procedures using an autologous transfusion system got significantly more ABTs than non-cemented procedures using an autologous transfusion system (p = 0.0042, odds ratio = 2.035).
  
  
  CONCLUSIONS
  Use of an autologous transfusion system did not reduce the amount of ABT in revision THA in the patient cohort reported here. In our opinion, general blood management is required before and during surgery to reduce administration of ABT.
authors.affiliation: Department of Orthopaedic Surgery, Helios ENDO-Klinik, Holstenstr. 2, 22767, Hamburg, Germany, hawi.nael@mh-hannover.de.
authors.forename: Nael
authors.initials: N
authors.lastname: Hawi
authors.forename: Daniel Oliver
authors.initials: DO
authors.lastname: Kendoff
authors.forename: Udo
authors.initials: U
authors.lastname: Hessling
authors.forename: Carl
authors.initials: C
authors.lastname: Haasper
authors.forename: Thorsten
authors.initials: T
authors.lastname: Gehrke
authors.forename: Mustafa
authors.initials: M
authors.lastname: Citak
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001804:Blood Transfusion, Autologous / Q000706:statistics & numerical data*; D001843:Bone Cements; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements