Preoperative crossmatch guidelines for total hip arthroplasty

The use of crossmatch guidelines has become commonplace as a means of guiding surgeons to efficient preoperative blood ordering. To further refine existing guidelines for a major elective procedure, a number of specific characteristics of 175 patients who underwent 189 total hip arthroplasties were correlated with blood use by univariate and multivariate analyses. The findings of this study demonstrate that for patients with no detectable red cell alloantibody, four units of blood should be crossmatched and reserved preoperatively if the patient is undergoing exchange arthroplasty, or undergoing a transtrochanteric procedure. All other patients with no detectable red cell alloantibody should have two units of blood reserved preoperatively. Proper preoperative crossmatch ordering can result in more labor-efficient and thrifty use of transfusion services, as well as increased effectiveness of autologous predeposit programs.