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[Clinical efficacy of blood retransfusion after uncemented total hip replacement]
Krzysztof Rekawek1, Andrzej Bohatyrewicz, Romuald Bohatyrewicz
1Katedra i Klinika Ortopedii i Traumatologii, Pomorska Akademia Medyczna w Szczecinie. rekawek@med.pam.szczecin.pl
THR is associated with high volume of perioperative blood loss. Concern about the risk of allogenic blood transfusion has led to attempts to avoid this standard procedure. Regarding different alternative method of allogenic blood transfusion postoperative collection of unwashed blood seems to be a good method of avoiding homologous blood transfusion. The purpose of this study was to investigate whether the postoperative salvaged blood after uncemented THR was efficacious. The patients were prospective assigned to one of two groups. The first group (34 patients) was managed with postoperative reinfusion of salvage blood and the second (32 patients) was treated with close suction drainage. We found that intraoperative blood loss was 456 +/- 82 ml and postoperative 847 +/- 172 ml. The decrease of hemoglobin level after first 6 hour was 2.78 +/- 0.49 g/dl. The first group with postoperative reinfusion of unwashed salvaged blood was associated with above double decreased prevalence of homologous transfusion after uncemented THR compared to the group without reinfusion. The hemoglobin level of unwashed salvaged blood used to retransfusion was not different compared to patient hemoglobin level measured 6 hours after THR. We found that the use of postoperative blood reinfusion after uncemented THR is a useful and practical method of reducing allogenic transfusion.
THR is associated with high volume of perioperative blood loss. Concern about the risk of allogenic blood transfusion has led to attempts to avoid this standard procedure. Regarding different alternative method of allogenic blood transfusion postoperative collection of unwashed blood seems to be a good method of avoiding homologous blood transfusion. The purpose of this study was to investigate whether the postoperative salvaged blood after uncemented THR was efficacious. The patients were prospective assigned to one of two groups. The first group (34 patients) was managed with postoperative reinfusion of salvage blood and the second (32 patients) was treated with close suction drainage. We found that intraoperative blood loss was 456 +/- 82 ml and postoperative 847 +/- 172 ml. The decrease of hemoglobin level after first 6 hour was 2.78 +/- 0.49 g/dl. The first group with postoperative reinfusion of unwashed salvaged blood was associated with above double decreased prevalence of homologous transfusion after uncemented THR compared to the group without reinfusion. The hemoglobin level of unwashed salvaged blood used to retransfusion was not different compared to patient hemoglobin level measured 6 hours after THR. We found that the use of postoperative blood reinfusion after uncemented THR is a useful and practical method of reducing allogenic transfusion.