Perioperative autologous blood transfusion in elective total hip prosthesis operations

The aim of this study was to determine if acute perioperative normovolaemic haemodilution with retransfusion of the autologous blood at the end of operation would reduce or eliminate the need for homologous (banked) blood. Forty patients scheduled for total hip prosthesis replacement (THPR) were randomly divided into two groups: Group A, 20 patients from whom 900 ml of blood was taken 20 min preoperatively, the volume being replaced with 1000 ml of gelatin solution (Haemaccel). Group B, 20 patients who were undergoing the same operation but from whom no blood was taken. Both groups were allowed a fall in haematocrit (Hct) to 0.25 before transfusion was started. A standard formula to calculate allowable blood loss plus intraoperative Hct measurements were used to achieve the haemodilution. There was no significant difference in blood loss between the two groups. Transfusion requirement was the same in the two groups. In this study, autotransfusion by the withdrawal of 900 ml of blood is inadequate to reduce the transfusion requirement further than that which can be achieved by haemodilution alone.