Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Jul;7(2):141-4.
doi: 10.1007/s11420-011-9200-9. Epub 2011 Jun 14.

Nonanemic patients do not benefit from autologous blood donation before total knee replacement

Stephen Kim  1 , Eric Altneu, Jad Bou Monsef, Elizabeth A King, Thomas P Sculco, Friedrich Boettner
Affiliations

Nonanemic patients do not benefit from autologous blood donation before total knee replacement

Stephen Kim et al. HSS J. 2011 Jul.

Abstract

A retrospective analysis of 221 patients undergoing unilateral total knee arthroplasty between January 2007 and April 2008 was performed to look at rates of total transfusions, allogenic transfusions, and autogenic transfusions. Two senior surgeons performed all the surgeries. During that period, patients in group A (129 patients) all donated one unit of autologous blood and patients in group B (92 patients) did not donate. Within both groups, patients were further divided by preoperative hemoglobin level as either anemic or non-anemic. A hemoglobin of 12.5 g/dL was used as the cutoff. Ninety-eight patients in group A (76%) required autologous blood. Patients in group A received a higher total number of transfusions (0.93 per patient) than those in group B (0.33 per patient; p < 0.001). The rate of allogenic transfusion was lower for group A (14%) than for group B (25%; p < 0.033). The reduction of allogenic transfusions associated with preoperative autologous blood donation was confined to anemic patients (29% in group A vs 72% in group B; p = 0.0006). There was no difference in allogenic blood transfusions in non-anemic patients between group A (8%) and group B (9%; p = 0.91). Limiting autologous blood donation to anemic patients decreased cost compared to routine autologous blood donation (US $256.63/patient versus US $511.44/patient) without exposing patients to increased allogenic blood transfusions. Targeted blood management in total knee replacement surgery decreases transfusion rates and reduces cost.

Keywords: autologous blood; blood management; primary total knee replacement; transfusion.

PubMed Disclaimer

References

    1. Bierbaum BE, Callaghan JJ, Galante JO, Rubash HE, Tooms RE, Welch RB. An analysis of blood management in patients having a total hip or knee arthroplasty. J Bone Joint Surg Am. 1999;81(1):2–10. doi: 10.2106/00004623-199901000-00002. - DOI - PubMed
    1. Biesma DH, Marx JJ, van de Wiel A. Collection of autologous blood before elective hip replacement. A comparison of the results with the collection of two and four units. J Bone Joint Surg Am. 1994;76(10):1471–1475. doi: 10.2106/00004623-199410000-00006. - DOI - PubMed
    1. Billote DB, Glisson SN, Green D, Wixson RL. A prospective, randomized study of preoperative autologous donation for hip replacement surgery. J Bone Joint Surg Am. 2002;84-A(8):1299–1304. doi: 10.2106/00004623-200208000-00003. - DOI - PubMed
    1. Bong MR, Patel V, Chang E, Issack PS, Hebert R, Di Cesare PE. Risks associated with blood transfusion after total knee arthroplasty. J Arthroplasty. 2004;19(3):281–287. doi: 10.1016/j.arth.2003.10.013. - DOI - PubMed
    1. Couvret C, Laffon M, Baud A, Payen V, Burdin P, Fusciardi J. A restrictive use of both autologous donation and recombinant human erythropoietin is an efficient policy for primary total hip or knee arthroplasty. Anesth Analg. 2004;99(1):262–271. doi: 10.1213/01.ANE.0000118165.70750.78. - DOI - PubMed