[Intra- and postoperative autotransfusion in hip joint surgery. Effectiveness, bacteriology]

The efficiency of intraoperative and postoperative autotransfusion with a cell separator, the elimination of a cephalosporin administered for prophylaxis of infection and bacterial contamination of the blood retransfused were studied in 56 patients undergoing hip arthroplasty (n = 33) or exchange reoperation of hip arthroplasty (n = 23). Intraoperatively only a limited amount of the lost erythrocytes could be retransfused: in hip arthroplasty 250 ml (median) packed red cells of 700 ml blood loss, in exchange reoperation 750 ml of 2200 ml. Postoperative autotransfusion was more effective: during the autotransfusion period (until 6 h after the beginning of the operation) 375 ml of 650 ml and 500 ml of 830 ml could be retransfused in the two groups. Cefuroxime was eliminated effectively from the autologous blood by the cell washing process, usually below the limit of detection. In the washed autologous red blood cells of 3 patients (= 5.4%) bacterial contamination could be demonstrated in low titres (less than or equal to 10/ml). No clinical signs of bacteremia were observed during retransfusion. Postoperative autotransfusion contributes considerably to the total amount of autologous erythrocytes retransfused. Bacterial contamination of the processed autologous blood is infrequent and probably without clinical significance.