Abstract
Background. The postoperative salvage and re-infusion of autologous blood, has become a very attractive alternative to allogenic transfusion, especially in patients that undergo primary Total Knee Arthroplasty (TKA). The increased demand for blood that is required during this operation, the fear of transfusion-related diseases and the continuingly increasing pressure that is forced on hospitals’ blood depots has rendered this procedure quite popular. In order to assess the efficacy of autologous blood drainage and re-transfusion as far as the amount of salvaged blood, the need for allogenic transfusion and the effect of this procedure on the postoperative haemoglobin value are concerned, we conducted a prospective study.
Methods. One hundred and fifty five patients suffering from primary osteoarthritis of the knee that were treated with TKA in 2002 were included in this study. A tourniquet was used in all cases. In Group A» (n=77) it was released prior to the wound closure in order to achieve haemostasis and 2 standard suction drains were then placed. In Group B» (n=78) it remained until the completion of the operation, an auto-transfusion system was placed and the salvaged blood was re-transfused within 6 hours postoperatively. Group’s «B» patients were further divided into 2 subgroups according to the administration or not of methylprednisolone before the auto-transfusion. The patients’ haemoglobin and platelets were measured before, at 8 and 24 hours after surgery. The days of postoperative fever were also noted.
Results. Over 170 units of blood were salvaged and re-transfused. No Group B» patient received allogenic blood preoperatively. Group’s B» patients received only 42 while Group’s A» 124 units of allogenic blood. Patients who received autologous blood had higher levels of haemoglobin at 8 (p< 0.05) and at 24 hours postoperatively (p< 0.01) and needed less allogenic blood (p< 0.01). The administration of methylprednisolone ameliorated the postoperative febrile movement (p=0.01).
Conclusions. Postoperative blood salvage and re-tperfusion in patients undergoing TKA, was found to be an efficient, safe and patient-beneficial method.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
