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Postoperative autologous blood transfusion with blood salvage device in the primary total hip replacement

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Author(s): AHL Wong

Journal: Journal of Orthopaedics
ISSN 0972-978X

Volume: 6;
Issue: 1;
Date: 2009;
Original page

Keywords: arthroplasty | total hip replacement | autologous blood transfusion | homologous blood transfusion

ABSTRACT
Abstract: Aim: The aim of the study was to determine whether post-operative autologous salvage system affects post-operative haemoglobin (Hb) levels and reduces the need for homologous blood transfusion (HBT). Methods: A prospective study of 211 patients who had undergone unilateral primary THR with their preoperative, post-operative Hb levels and requirement of homologous banked blood recorded. Cell Saver 5 was used post-operatively for autologous blood transfusion. Results: A total 211 patients with mean age of 70 years was enrolled to the study and complete data were obtained perioperatively. The mean pre-operative and post-operative Hb levels were 137.1g/L and 105.1g/L, respectively. Twenty-four units of homologous red blood were transfused to twelve (5.4%) patients, with a mean of 0.109 units per case. There were 65 patients (29.4%) older than 75 years, with 9 patients having pre-operative Hb less than 120 g/L. Patients older than 75 years were associated with a greater use of homologous blood with those equal or under the age of 75 years (chi-squared test, p = 0.001). Mean of in-hospital stay was 6 days. No transfusion-related and wound-related complications were reported.Discussion: Primary THR can be safely performed without requiring HBT in patients without pre-existing haematological disorder using autologous retransfusion system. This study has shown that use of an autologous retransfusion system for primary THR reduces the necessity for HBT. Post-operative blood salvage also results in lesser patients dropping their post-operative Hb level below 9.0 g/L (15.8%).
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