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Meta-Analysis
. 2016 Nov 2;17(1):452.
doi: 10.1186/s12891-016-1301-7.

The efficacy and safety of autologous blood transfusion drainage in patients undergoing total knee arthroplasty: a meta-analysis of 16 randomized controlled trials

Jian-Ke Pan  1 , Kun-Hao Hong  2 , Hui Xie  1 , Ming-Hui Luo  1 , Da Guo  1 , Jun Liu  3
Affiliations
Meta-Analysis

The efficacy and safety of autologous blood transfusion drainage in patients undergoing total knee arthroplasty: a meta-analysis of 16 randomized controlled trials

Jian-Ke Pan et al. BMC Musculoskelet Disord. .

Abstract

Background: Autologous blood transfusion drainage (ABTD) has been used for many years to reduce blood loss in total knee arthroplasty (TKA). We evaluate the current evidence concerning the efficiency and safety of ABTD used in TKA compared with conventional suction drainage (CSD).

Methods: We performed a systematic literature search of the PubMed, Embase, Cochrane Library and four Chinese databases. All randomized controlled trials (RCTs) that compared the effects of ABTD versus CSD in TKA were included in the meta-analysis.

Results: Sixteen RCTs involving 1534 patients who compared the effects of ABTD versus CSD were included. Five of the RCTs were performed in Asia, ten in Europe, and one in North America. Patients in the ABTD group had a lower blood transfusion rate (OR: 0.25 [0.13, 0.47]; Z = 4.27, P < 0.0001) and fewer units transfused per patient (WMD: -0.68 [-0.98, -0.39]; Z = 4. 52, P < 0.00001) than did patients in the CSD group. Wound complications, deep vein thrombosis, febrile complications, post-operative hemoglobin days 5-8, drainage volume, and length of hospital stay did not differ significantly between the two types of drainage systems.

Conclusion: This meta-analysis suggests that ABTD is a safe and effective method that yields a lower blood transfusion rate and fewer units transfused per patient in TKA compared with CSD.

Keywords: Autologous blood transfusion drainage; Meta-analysis; Randomized controlled trials; Total knee arthroplasty.

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Figures

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Flow diagram of studies identified, included, and excluded
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Risk of bias summary
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Risk of bias assessment
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Blood transfusion rate
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Mean number of units transfused per patient
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Wound complication
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Deep vein thrombosis
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Febrile complications
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Post-operative haemoglobin days 5–8
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Drainage volume
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Length of hospital stay
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Funnel plot of blood transfusion rate
See this image and copyright information in PMC

References

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