Intraoperative cell salvage in revision hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Transfusion Medicine

Background:

• Revision hip arthroplasty can involve significant blood loss, increasing the need for allogenic blood transfusions.
• Intraoperative cell salvage (ICS) is a technique to recover and reinfuse a patient's own blood lost during surgery.

Approach:

• A systematic review and meta-analysis of studies published up to February 2022 was conducted.
• Included studies focused on patients over 18 undergoing revision hip arthroplasty with ICS, excluding those using pre-donated autologous blood.
• Data were analyzed using a random effects model to quantify the impact of ICS on allogenic transfusion rates and volumes.

Key Points:

• The use of ICS was associated with a significant reduction in the proportion of patients requiring allogenic transfusion (OR 0.331, p < 0.001).
• 44.0% of patients receiving ICS required allogenic transfusion compared to 65.0% of those not receiving it.
• The mean volume of allogenic blood transfused was significantly lower in the ICS group (1.95 units) versus the non-ICS group (3.25 units).

Conclusions:

• Intraoperative cell salvage significantly reduces the need for and volume of allogenic blood transfusions in revision hip arthroplasty.
• The findings support the routine implementation of ICS in revision hip arthroplasty procedures.
• Further research is needed to explore the impact of ICS across different complexities of revision arthroplasty.