Postoperative autotransfusion after total knee arthroplasty

To evaluate the quality of shed blood postoperatively after total knee arthroplasty (TKA), the safety of autotransfusion, and to minimize homologous transfusion, the Autovac system was used for reinfusion of whole blood following cemented TKA. The system was used in 50 consecutive patients who were reinfused an average of 420 cc of whole blood. Twenty-five patients had a calcium binding resin anticoagulant within the collection canister. A second group of 25 patients had 40 cc of acid citrate dextrose anti-coagulate (ACD-A) in the collection canister as an anticoagulant. Fifteen hematologic parameters were measured during five time periods. Each study group was compared to a control group of 25 TKAs with a standard drain. The clinical safety of auto-transfusion with ACD-A was proven. Blood collected in the calcium binding resin had a statistically significant higher hemoglobin (P < .05), plasma-free hemoglobin (P < .05), fibrin split products (P < .05), and a different white blood cell differential.