Free Content Efficacy and economics of postoperative blood salvage in patients undergoing elective total hip replacement

Authors: Mirza, Saqeb B.1; Campion, Jon1; Dixon, John H.1; Panesar, Sukhmeet S.2

Source: Annals of The Royal College of Surgeons of England, Volume 89, Number 8, November 2007 , pp. 777-784(8)

Publisher: The Royal College of Surgeons of England

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Abstract:

INTRODUCTION: Patients undergoing total hip replacement (THR) regularly receive allogenic blood transfusions. The infusion of allogenic blood exposes the recipient to significant risks including the transmission of infection, anaphylactic and haemolytic reactions. The purpose of this study was to determine the effect of introducing a system to retransfuse salvaged drainage blood in patients undergoing primary THR.

PATIENTS AND METHODS: We reviewed records of 109 consecutive patients who underwent THR following the introduction of the ABTrans autologous retransfusion system at our institution in January 2000. For comparison, we reviewed the medical records of 109 patients who underwent the same procedure immediately before the introduction of the retransfusion system.

RESULTS: Overall, 9% of patients treated with blood salvage and 30% treated without blood salvage required allogenic blood transfusions. Patients treated with the salvage system had significantly smaller haemoglobin drops in the peri-operative period (difference 0.56 g/dl; P = 0.001). The overall cost of using the retransfusion system was similar to that of routine vacuum drainage when the savings of reduced allogenic blood transfusion were taken into account.

CONCLUSIONS: The retransfusion of postoperative drainage blood is a simple, effective and safe way of providing autologous blood for patients undergoing primary THR.

Keywords: BLOOD SALVAGE; TRANSFUSION; HIP REPLACEMENT

Document Type: Research article

DOI: 10.1308/003588407X209310

Affiliations: 1: Department of Orthopaedics, Weston General Hospital, Weston-super-Mare, Somerset, UK 2: Imperial College of Science, Technology and Medicine, London, UK

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