[Decrease in allogenic transfusions due to the spread of use of postoperative retransfusion systems in knee...

Area of Science:

• Orthopedic Surgery
• Transfusion Medicine
• Patient Blood Management

Background:

• Postoperative allogenic transfusion is a concern in total knee replacement (TKR).
• Postoperative autotransfusion of unwashed shed blood has been implemented in TKR since 2006.
• Evaluating the impact of this practice on allogenic transfusion rates is crucial.

Purpose of the Study:

• To assess the effectiveness of postoperative autotransfusion in reducing allogenic blood transfusions.
• To compare transfusion rates before and after the implementation of the retransfusion system in TKR surgery.

Main Methods:

• Retrospective study comparing two cohorts: 2004 (pre-retransfusion) and 2008 (post-retransfusion).
• Data collected included demographics, hemoglobin levels, erythrocyte loss, and transfusion status.
• Statistical analysis compared outcomes between the two groups.

Main Results:

• No significant differences in gender, preoperative/postoperative hemoglobin, or erythrocyte loss between groups.
• Transfusion rate in the 2008 group (20.18%) was significantly lower than in the 2004 group (42.19%).
• Relative risk of transfusion was 0.47, with a Number Needed to Treat (NNT) of 4.54.

Conclusions:

• Postoperative autotransfusion systems effectively reduce the proportion of patients requiring allogenic transfusions during TKR hospitalization.
• The findings suggest a significant benefit of implementing autotransfusion protocols.
• Generalizability may be limited by the absence of a fixed transfusion trigger in the study.