Transfusion practice in elective orthopaedic surgery.

Area of Science:

• Orthopedic Surgery
• Transfusion Medicine
• Patient Blood Management

Background:

• Total hip and knee arthroplasty procedures have significant transfusion requirements.
• Autologous blood donation (ABD) is a potential strategy to mitigate these needs.
• Current utilization of ABD programs in arthroplasty patients is low.

Purpose of the Study:

• To evaluate transfusion requirements in total hip and knee arthroplasty patients.
• To assess the uptake and effectiveness of autologous blood donation (ABD) programs.
• To identify risk factors for allogeneic transfusions and evaluate predictive models.

Main Methods:

• Retrospective analysis of 2233 patients undergoing hip or knee arthroplasty.
• Comparison of transfusion rates between patients who predonated autologous blood and those who did not.
• Identification of risk factors associated with allogeneic transfusions.

Main Results:

• Only 8% of eligible patients (64% of total) predonated blood.
• Patients who predonated had significantly lower allogeneic transfusion rates (9.0% vs. 24.1%).
• Key risk factors for allogeneic transfusion included procedure type, lower hemoglobin, lower weight, older age, and rheumatoid arthritis.

Conclusions:

• Autologous blood donation (ABD) is effective in reducing allogeneic transfusion rates in arthroplasty patients.
• There is a substantial gap between eligibility for ABD and actual participation.
• Increased promotion of ABD and implementation of alternative strategies for ineligible patients are necessary to reduce allogeneic transfusion rates.