Auto-Transfusion in Total Knee Arthroplasty

ABSTRACT

PURPOSE: The purposes of this study are to see how much the auto-transfusion reduce the need for allo- genic blood transfusion and to ascertain whether transfusion affects the incidence of deep vein thrombo- sis(DVT) in primary total knee arthroplasty(TKA). MATERIALS AND METHODS: A retrospective analysis of 263 consecutive patients who had had a primary TKA was performed. The operations included 165 unilateral and 98 one-stage bilateral cases. The predeposit autologous blood donated 1pint for the unilateral cases and 2pints for bilateral cases preoperatively. Intraoperative salvage of blood was performed using the cell saver system. The collected data from the patients charts(the estimated blood loss and the amount of transfusion) were statistically analysed to examine relationships between development of DVT and the loss of blood or transfusion. RESULTS: We excluded the data of the patients who needed to be transfused over 6pints. For the unilateral cases, the average estimated loss of blood was 307+/-150cc(50~1000), the average amount of transfusion was 1.5+/-0.8 pint(0~5), and the average amount of blood that was salvaged through cell saver system was 210+/-141 cc(0~660). Adding the autologous donation(400cc), auto-transfusion was up to 100% of the average amount of transfusion. For the one-stage bilateral cases, the average estimated loss of blood was 678+/-267cc(100~1400), the average amount of transfusion was 3.0+/-0.9 pint(1~5), and the average amount of blood that was salvaged through cell saver system was 524+/-279cc(125~1125), Adding the autologous donation(800cc), auto-transfusion was up to 100% of the average amount of transfusion. There were no statistical associations between DYT and the loss of blood or transfusion(p>0.05). CONCLUSION: Combining preoperative autologous blood donation with intraoperative salvage effectively reduces the need for allogenic blood transfusion in primary TKA.