Reinfusion of drained blood as an alternative to homologous blood transfusion after total knee replacement

Abstract

In patients undergoing total knee replacement we carried out a longitudinal cohort study to determine the efficacy and safety of a postoperative autologous blood reinfusion system, as an alternative to homologous, banked blood transfusions. Fifty patients received reinfusion of unwashed, filtered, shed blood, supplemented with banked blood transfusions as required. A control group of 50 patients in whom standard suction drains were used received homologous blood transfusions as required. In the study group, the homologous blood requirement was reduced by 80%. There was no significant difference in the postoperative haemoglobin values between the two groups. None of the patients developed any adverse reactions after reinfusion.Résumé Chez des patients opérés par arthroplastie totale du genou nous avons fait une étude par cohorte longitudinale pour déterminer l'efficacité et la sécurité d'un système de réinfusion du sang de drainage postopératoire, comme une alternative aux transfusions de sang homologue. Cinquante patients ont eu une reinfusion du sang autologue filtré, complété par des transfusions de sang homologue selon les besoins. Un groupe témoin de 50 patients avec drainage standard a reçu des transfusions de sang homologue comme nécessaire. Dans le groupe de l'étude, la nécessité de sang homologue a été réduite de 80%. Il n'y avait aucune différence notable des taux postopératoires d'hémoglobine entre les deux groupes. Aucun des malades n'a présenté d'effet secondaire après reinfusion.

Autologous blood transfusion following total knee arthroplasty: is it always necessary?

“…Our results are in agreement with published series (Table 2). Our results are comparable to those of Sinha et al [15], who showed that homologous blood use can be reduced with the use of autologous transfusion following TKR. They reported an 80% drop in the rate of homolgous blood transfusion with the use of ABT.…”

Transfusion of autologous blood from reinfusion systems in total knee arthroplasty

“…Different studies [6,7,18,19,23,24] have reported a decreased blood transfusion requirement using a postoperative autologous blood reinfusion system. Peter et al [19] reported a blood transfusion requirement in the study group without an autologous blood reinfusion system in 67 of 93 patients (72%) which dropped to 19% using a reinfusion system.…”

“…Some surgeons use a reinfusion system of autologous blood [19,23] and others use closed suction drainage [11] following elective knee arthroplasty. Theoretically, a wound drain should minimise postoperative haematoma and all of the complications with which it is associated [4].…”

Tranexamic Acid Reduces Blood Loss and Blood Transfusion after TKA: A Prospective Randomized Controlled Trial

“…transfusions include autologous blood transfusion [10,34,37], postoperative blood salvage [1,9,16,20,21,34,52], use of a femoral intramedullary plug [43], hypotensive anesthesia [30], cryotherapy and Jones bandage [18], use of fibrin tissue adhesive [33,58], drain clamping [41,42,45,46,48,51,54,59], and administration of tranexamic acid [6-8, 19, 23, 24, 27, 28, 35, 39, 53, 55].…”