title: Efficiency and cost analysis of cell saver auto transfusion system in total knee arthroplasty.
abstract: BACKGROUND
  Blood loss and replacement is still a controversial issue in major orthopaedic surgery. Allogenic blood transfusion may cause legal problems and concerns regarding the transmission of transfusion-related diseases. Cellsaver Systems (CSS) were developed as an alternative to allogenic transfusion but CSS transfusion may cause coagulation, infection and haemodynamic instability.
  
  
  OBJECTIVE
  Our aim was to analyse the efficiency and cost analysis of a cell saver auto-transfusion system in the total knee arthroplasty procedure.
  
  
  METHODS
  Retrospective comparative study.
  
  
  METHODS
  Those patients who were operated on by unilateral, cemented total knee arthroplasty (TKA) were retrospectively evaluated. Group 1 included 37 patients who were treated using the cell saver system, and Group 2 involved 39 patients who were treated by allogenic blood transfusion. The groups were compared in terms of preoperative haemoglobin and haematocrit levels, blood loss and transfusion amount, whether allogenic transfusion was made, degree of deformity, body mass index and cost.
  
  
  RESULTS
  No significant results could be obtained in the statistical comparisons made in terms of the demographic properties, deformity properties, preoperative laboratory values, transfusion amount and length of hospital stay of the groups. Average blood loss was calculated to be less in Group 1 (p<0.05) and cost was higher in Group 1 (p<0.05).
  
  
  CONCLUSIONS
  Cell saver systems do not decrease the amount of allogenic blood transfusion and costs more. Therefore, the routine usage of the auto-transfusion systems is a controversial issue. Cell saver system usage does not affect allogenic blood transfusion incidence or allogenic blood transfusion volume. It was found that preoperative haemoglobin and body mass index rates may affect allogenic blood transfusion. Therefore, it is foreseen that auto-transfusion systems could be useful in patients with low haemoglobin level and body mass index.
authors.affiliation: Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey.
authors.forename: Mustafa Gökhan
authors.initials: MG
authors.lastname: Bilgili
authors.affiliation: Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey.
authors.forename: Ersin
authors.initials: E
authors.lastname: Erçin
authors.affiliation: Department of Orthopedics and Traumatology, Trabzon Kanuni Research and Training Hospital, Trabzon, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Peker
authors.affiliation: Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey.
authors.forename: Cemal
authors.initials: C
authors.lastname: Kural
authors.affiliation: Department of Orthopedics and Traumatology, Karabük University Faculty of Medicine, Zonguldak, Turkey.
authors.forename: Serdar Hakan
authors.initials: SH
authors.lastname: Başaran
authors.affiliation: Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey.
authors.forename: Altuğ
authors.initials: A
authors.lastname: Duramaz
authors.affiliation: Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey.
authors.forename: Cevdet
authors.initials: C
authors.lastname: Avkan
keywords: Cell saver system; cost; total knee arthroplasty