The Effect of Aprotinin for Reducing Blood Loss and Amount of Transfusion in Total Knee Arthroplasty

ABSTRACT

PURPOSE: To evaluate the effect of Aprotinin in reducing postoperative blood loss and amount of transfusion in total knee arthroplasty. MATERIALS AND METHODS: In a prospective study, 100 patients undergoing bilateral total knee arthroplasty were investigated. A low dose Aprotinin was administred in randomly selected fifty patients and the other fifty patients were selected as control group. Postoperative blood loss, the amount of intraoperative and postoperative transfusion, preoperative and postoperative value of hemoglobin and hematocrit were evaluated and statiscally compared. Postoperative complications were assessed. RESULTS: Significant reduction in postoperative total blood loss was observed (Aprotinin group1195 ml, control group2216 ml). The amount of packed red blood cells transfusion was also reduced in Aprotinin group (Aprotinin group 2.0 units, control group 4.0 units), and fresh frozen plasma (Aprotinin group 0.1units, control group 1.2 units) as well. Aprotinin also reduced the decline in hemoglobin and hematocrit levels at the first, second and fourth postoperative days. There were no clinical evidence of complications such as anaphylactic shock, deep vein thrombosis, thromboembolism, myocardiac infarction and acute renal failure. CONCLUSION: Aprotinin is safe and effective in reducing postoperative blood loss and amount of blood transfusion in total knee arthroplasty.