title: Do autologous blood transfusion systems reduce allogeneic blood transfusion in total knee arthroplasty?
abstract: OBJECTIVE
  To study whether autologus blood transfusion systems reduce the requirement of allogneic blood transfusion in patients undergoing total knee arthroplasty.
  
  
  METHODS
  A comprehensive search of the published literature with PubMed, Scopus and Science direct database was performed. The following search terms were used: (total knee replacement) OR (total knee arthroplasty) OR (TKA) AND (blood transfusion) OR (autologous transfusion) OR (autologous transfusion system). Using search syntax, a total of 748 search results were obtained (79 from PubMed, 586 from Science direct and 83 from Scopus). Twenty-one randomized control trials were included for this meta-analysis.
  
  
  RESULTS
  The allogenic transfusion rate in autologus blood transfusion (study) group was significantly lower than the control group (28.4 and 53.5 %, respectively) (p value 0.0001, Relative risk: 0.5). The median units of allogenic blood transfused in study control group and control group were 0.1 (0.1-3.0) and 1.3 (0.3-2.6), respectively. The median hospital stay in study group was 9 (6.7-15.6) days and control group was 8.7 (6.6-16.7) days. The median cost incurred for blood transfusion per patient in study and control groups was 175 (85.7-260) and 254.7 (235-300) euros, respectively.
  
  
  CONCLUSIONS
  This meta-analysis demonstrates that the use of auto-transfusion systems is a cost-effective method to reduce the need for and quantity of allogenic transfusion in elective total knee arthroplasty.
  
  
  METHODS
  Level I.
authors.affiliation: L.T. Medical College, Sion, Mumbai, India.
authors.forename: Aditya
authors.initials: A
authors.lastname: Pawaskar
authors.affiliation: Department of Orthopedics, Pramukswami Medical College, Anand, Gujrat, India. drabhijeetsalunke@gmail.com.
authors.forename: Abhijeet Ashok
authors.initials: AA
authors.lastname: Salunke
authors.affiliation: D.Y. Patil Medical College, Mumbai, India.
authors.forename: Aashay
authors.initials: A
authors.lastname: Kekatpure
authors.affiliation: Department of Orthopedics, National University Hospital, Singapore, Singapore.
authors.forename: Yongsheng
authors.initials: Y
authors.lastname: Chen
authors.affiliation: K.M. Nallasamy Hospital, Erode, Tamil Naidu, India.
authors.forename: G I
authors.initials: GI
authors.lastname: Nambi
authors.affiliation: Department of Orthopedics, National University Hospital, Singapore, Singapore.
authors.forename: Junhao
authors.initials: J
authors.lastname: Tan
authors.affiliation: J.J. Hospital, Mumbai, India.
authors.forename: Dhiraj
authors.initials: D
authors.lastname: Sonawane
authors.affiliation: Department of Orthopedics, Pramukswami Medical College, Anand, Gujrat, India.
authors.forename: Subodhkumar
authors.initials: S
authors.lastname: Pathak
mesh_terms: D019645:Arthroplasty, Replacement, Knee; D001803:Blood Transfusion / Q000191:economics / Q000706:statistics & numerical data*; D001804:Blood Transfusion, Autologous; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data
keywords: Allogenic blood transfusion; Autologous transfusion; Autologous transfusion system; Meta-analysis; Randomized control trials; Total knee arthroplasty