Autologous blood reinfusion in patients undergoing bilateral total hip arthroplasty

To compare the rate and unit of allogeneic blood transfusion in one-stage bilateral total hip arthroplasty (THA) in patients with and without autologous blood reinfusion.

Records of a consecutive series of 43 men and 33 women aged 25 to 83 (mean, 55) years who underwent one-stage sequential bilateral THA by a single surgeon were reviewed. Their risks of cardiopulmonary complications were minimal. At least 4 weeks prior to surgery, 38 of the patients donated 2 units of autologous blood in 2 stages (one to 2 weeks apart). The remaining 38 patients did not donate blood owing to personal preferences or logistical reasons. All pre-donated autologous blood was transfused back to the patients in the recovery room. Estimated blood loss volume, blood salvaged volume, and complications were recorded, as were pre- and post-operative haemoglobin levels. The 2 groups were compared with respect to the rate and unit of allogeneic blood transfusion.

The mean estimated blood loss was 939 (SD, 448; range, 200-2500) ml. The mean volume of blood salvaged was 302 (SD, 196; range, 0-850) ml, representing a collection rate of 32%. In patients with and without autologous blood reinfusion, 16 (42%) and 33 (87%) patients received allogeneic blood transfusion of 0.9 and 2.4 units, respectively (p<0.0001). Four patients developed major cardiopulmonary complications. None had deep venous thrombosis or pulmonary embolism. No complications resulted from blood transfusion. The 2 groups were not significantly different in complication rate (13% vs. 18%, p=0.54) and discharge haemoglobin levels.

Autologous blood reinfusion was effective in reducing the rate and unit of allogeneic blood transfusion in patients undergoing one-stage bilateral THA.