Preoperative autologous blood donation in primary total knee arthroplasty: critical review of current indications

Abstract

Preoperative autologous blood donation (PABD) is a well established transfusion practice in elective orthopaedic surgery, involving immunologic and infective advantages but also involving exposure to not negligible risks, and costs as well. The aim of this study was to assess the real need for blood transfusions in primary total knee arthroplasty (TKA). Between January 2000 and July 2005, 214 patients underwent primary unilateral TKA. Altogether, 416 autologous blood units were collected, however only 47 (11.3%) were transfused. Thirty-eight patients (17.8%) received autologous blood, while 4 of them (10.5%) also received allogeneic blood. Based on the results of this study, PABD should be recommended in well selected patients undergoing TKA: older female patients with a low basal haemoglobin level.

Net haemoglobin increase from reinfusion of refrigerated vs. frozen red blood cells after autologous blood transfusions

“…Preoperative autologous blood donation (PABD) is recognized as being advantageous in elective surgery settings to avoid immunological and infective complications associated with allogeneic blood transfusion [1]. PABD flourished in the 1980s consequent to the emerging risk of transfusion‐transmitted HIV infection [2].…”

Blood conservation strategies in orthopedic surgeries: A review

“…9 In one study out of 416 units donated only 47 have been used, the rest were discarded. 10 Hence its use has to be rationalized depending on the situation. It has several limitations and adverse effects.…”

Evaluation of blood loss and significance of postoperative autotransfusion in knee joint alloplasty

“…Pod sta wo wym pro ble mem są jej wy so kie kosz ty, wy ni ka ją ce z fak tu, że 50-70% po bra nej przed ope ra cyj nie krwi nie jest wy ko rzy stywa ne, a z re gu ły nie wy ko rzy sta na krew nie jest przeta cza na in nym cho rym [7][8][9][10][11]. Do bit nie fakt ten po kazu ją wy ni ki ba dań Re gio i wsp., we dług któ rych na 214 przy pad ków alo pla sty ki sta wu ko la no we go za bezpie czo no przed ope ra cyj nie 416 jed no stek krwi, z których tyl ko 47 (11,3%) zo sta ło prze to czo nych [12].…”

“…Śred nia war tość Hb przed ope ra cją wy nio sła 13,5 g/dl (9,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)5) i by ła zde cy do wa nie naj ni ższa wśród cho rych, któ rzy po mi mo au to trans fu zji, wy ma ga li prze to cze nia krwi al lo ge nicz nej (11,8 g/dl; 10,2 -13,4). Rów nież śred nia po ope ra cyj na war tość Hb by ła najni ższa w tej gru pie (8,36 g/dl; 7,4-9,2) w po rów na niu ze śred nią dla wszyst kich cho rych (9,7 g/dl; 8,5-13,0).…”

“…The main concern is the high cost as 50 to 70% of the blood collected preoperatively remains unused and it is usually not utilized for transfusion to other patients [7][8][9][10][11]. This has been demonstrated clearly in a recent study by Regio et al, who investigated 214 cases of knee joint alloplasty where 416 units of blood had been secured preoperatively, of which only 47 (11.3%) were trans fused [12].…”