Targeted preoperative autologous blood donation in total knee arthroplasty reduces the need for postoperative transfusion. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Preoperative donation of autologous blood has been widely used to minimize the potential risk of allogeneic transfusions in total knee arthroplasty. A previous study from our center revealed that preoperative autologous donation reduces the allogeneic blood exposure for anemic patients but has no effect for non-anemic patients. QUESTIONS/PURPOSES: The current study investigates the impact of a targeted blood donation protocol on overall transfusion rates and the incidence of allogeneic blood transfusions. METHODS: Prospectively, 372 patients undergoing 425 unilateral primary knee replacements were preoperatively screened by the Blood Preservation Center between 2009 and 2012. Anemic patients with a hemoglobin level less than 13.5 g/dL were advised to donate blood, while non-anemic patients did not donate. RESULTS: Non-anemic patients who did not donate blood required allogeneic blood transfusions in 5.9% of the patients. The overall rate of allogeneic transfusion was significantly lower for anemic patients who donated autologous blood (group A, 9%) than those who did not donate (group B, 33%; p < 0.001). Donating autologous blood did increase the overall transfusion rate of anemic patients to 0.84 per patient in group A compared to 0.41 per patient in group B (p < 0.001). CONCLUSION: This investigation confirms that abandoning preoperative autologous blood donation for non-anemic patients does not increase allogeneic blood transfusion rates but significantly lowers overall transfusion rates.

publication date

  • August 16, 2013

Identity

PubMed Central ID

  • PMC3772157

Scopus Document Identifier

  • 17744377778

Digital Object Identifier (DOI)

  • 10.1213/01.ANE.0000150610.44631.9D

PubMed ID

  • 24039613

Additional Document Info

volume

  • 9

issue

  • 3