[Fewer blood transfusions after introduction of auto-transfusion system as part of hip- and knee-replacement surgery]

To establish the effect of the introduction of an auto-transfusion system on the number of homologous blood transfusions required as part of total hip- and knee-replacement surgery.

Prospective observational study.

The number of homologous blood transfusions required after total hip or knee replacement was compared between a group of 195 patients before and a group of 176 patients after introduction of an auto-transfusion system. The '4-5-6 Flexinorm' was strictly implemented when deciding to use homologous blood transfusion. Composition of the groups and the number of transfusion units of homologous blood (packed cells) required were compared using Student's t test and the chi2 test. In addition multivariate logistic regression analysis was used with the following variables as risk factors for requirement of homologous blood transfusion: gender, age, type of surgery and the use of an auto-transfusion system.

After introduction of the auto-transfusion system there was a reduction in the number of transfusion units given in both the hip- and the knee-replacement group (83% and 98% respectively). The use of the auto-transfusion system was the only variable for prediction of the requirement for homologous blood transfusion in the logistic regression model.

After the introduction of an auto-transfusion system there was a reduction in the number of homologous blood transfusions required as part of total hip and knee surgery.