Introduction and purpose: There has been a great increase in prosthetic surgery. The demand for homologous blood is higher than the supply in blood banks. We must bear in mind the adverse effects of homologous blood transfusion: incompatibility reactions, metabolic disorders, risk of disease transmission. There are alternatives to homologous blood: autotransfusion methods.
Materials and methods: Knee prostheses were implanted in 60 patients between 2002 and 2003 using the CBCII Constavac Blood Conservation System and reinfusion of the harvested blood. We analysed epidemiological data, ASA, harvested blood volume, haematology values, need for homologous blood transfusion and complications.
Results: 60 prostheses. Mean duration of surgery 121 minutes, mean hospital stay 8 days. 83.3% women, mean age 66.2 years. Harvested volume 677.5 ml (±221.3). Homologous transfusion was required in 9 cases. Haematocrit and haemoglobin tests were performed prior to surgery and at 24, 48 and 72 hours with the following results, respectively: 40.87, 13.4; 31.39, 10.4; 30.06, 10.05; 30.75, 10.2. Complications: fever (7), nausea (3).
Conclusions: Autotransfusion reduces the need for homologous blood. Harvested blood is an excellent source of erythrocytes and platelets. There are few adverse effects if reinfusion takes place within 6 hours and the volume is not over 1,000 ml. The association of different autotransfusion techniques and other more recent ones such as EPO and intravenous iron could make transfusion of homologous blood unnecessary in over 90% of patients.
