Allogeneic blood transfusion decreases with postoperative autotransfusion in hip and knee arthroplasty

Atay, Enver

doi:10.3944/aott.2010.2417

Cited by 14 publications

(20 citation statements)

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“…Based on the full articles, eight studies fulfilled the inclusion criteria and were included in addition to the thirty-five studies identified by Carless et al 1 . Of these fortythree included studies (5631 patients), eleven included only THA 4,12-21 , nineteen included only TKA 5,22-39 , six included both THA and TKA 6,[40][41][42][43][44] , and seven studies could not be split up or included other orthopaedic procedures [45][46][47][48][49][50][51] . The Appendix summarizes the characteristics and the risk-of-bias assessment of all included studies.…”

Section: Resultsmentioning

confidence: 99%

Cell Salvage in Hip and Knee Arthroplasty

Bodegom‐Vos

Voorn

So‐Osman

et al. 2015

The Journal of Bone and Joint Surgery

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Section: Resultsmentioning

confidence: 99%

Cell Salvage in Hip and Knee Arthroplasty

Bodegom‐Vos

Voorn

So‐Osman

et al. 2015

The Journal of Bone and Joint Surgery

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“…Preoperative autologous blood donation has been introduced in an attempt to decrease allogeneic blood usage and the associated risks. 15 However, the autologous blood donation process can be complex, expensive, and wasteful when unneeded units are discarded (up to 86.3% of autologous blood units, in one study), 16 and can carry cardiovascular risk for elderly patients who have limited cardiorespiratory reserve. In addition, there is an increased risk of perioperative anemia secondary to lower preoperative hemoglobin in patients who donated autologous blood preoperatively, 17,18 which may lead to a paradoxically higher rate of postoperative transfusion and longer hospital stay.…”

Section: Blood Managementmentioning

confidence: 99%

Protocol-Based Arthroplasty: Less Is More

Gutowski¹,

Parvızı²,

Purtill³

2015

Orthopedics

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As a result of reading this article, physicians should be able to: 1. State an argument for, and background information on, patient-centered arthroplasty protocols. 2. Describe specific recommendations for designing a simplified arthroplasty care pathway that is reproducible in other institutions. 3. Discuss cost-effectiveness research on the latest value-delivering protocols. 4. Recognize areas of continued research and opportunities for future improvement in protocol development. Total joint arthroplasty is a successful orthopedic procedure that is performed in high volume in the United States and internationally. As economic pressures continue to mount in the US health care system, it will become increasingly important to minimize cost and improve quality and value. At the authors' institution, a protocol-based arthroplasty model is used, in many ways based on simplification of the patient care pathway. The largely evidence-based protocol has its foundation in eliminating unnecessary dogmatic practices, enhancing the patient experience, and achieving cost-effectiveness. The authors believe that a model like this can be applied to joint arthroplasty practices across the country in the future to maximize the value delivered to patients.

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“…Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are major orthopedic surgeries. Both procedures are associated with significant blood loss, generally from bone osteotomies, severed muscles, periosteal bleeding, and some patient-related factors such as bleeding disorders and comorbidities [ 1 , 2 ]. It is estimated that perioperative blood loss is between 1000 mL and 1500 mL in TKA and that 18–95% of patients require donor transfusions [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Application of postoperative autotransfusion in total joint arthroplasty reduces allogeneic blood requirements: a meta-analysis of randomized controlled trials

Lin

Zhang

et al. 2017

BMC Musculoskelet Disord

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BackgroundTotal joint arthroplasty is associated with significant blood loss and often requires blood transfusion. However, allogeneic blood transfusion (ABT) may lead to severe problems, such as immunoreaction and infection. Postoperative autotransfusion, an alternative to ABT, is controversial. We conducted a meta-analysis to evaluate the ability of postoperative autotransfusion to reduce the need for ABT following total knee arthroplasty (TKA) and total hip arthroplasty (THA).MethodsSystematic literature searches for randomized controlled trials were performed using PubMed, Embase, and the Cochrane Library until February 2016. Relative risks (RRs) and weighted mean differences with 95% confidence intervals (CIs) were calculated using fixed-effect or random-effect models; we also evaluated publication bias and heterogeneity.ResultsSeventeen trials with a total of 2314 patients were included in the meta-analysis. The pooled RRs of ABT rate between autotransfusion and the regular drainage/no drainage groups for TKA and THA were 0.446 (95% CI = 0.287, 0.693; p < 0.001) and 0.757 (95% CI = 0.599, 0.958; p = 0.020), respectively. In the subgroup analysis performed in TKA patients according to control interventions, the pooled RRs were 0.377 (95% CI = 0.224, 0.634; p < 0.001) (compared with regular drainage) and 0.804 (95% CI = 0.453, 1.426, p = 0.456) (compared with no drainage). In the subgroup analysis performed for THA, the pooled RRs were 0.536 (95% CI = 0.379, 0.757, p < 0.001) (compared with regular drainage) and 1.020 (95% CI = 0.740, 1.405, p = 0.904) (compared with no drainage).ConclusionsCompared to regular drainage, autotransfusion reduces the need for ABT following TKA and THA. This reduction is not present when comparing autotransfusion to no drainage. However, the reliability of the meta-analytic results concerning TKA was limited by significant heterogeneity in methods among the included studies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-017-1710-2) contains supplementary material, which is available to authorized users.

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Allogeneic blood transfusion decreases with postoperative autotransfusion in hip and knee arthroplasty

Abstract: The need and amount of allogeneic transfusion were reduced with postoperative autotransfusion in both knee and hip arthroplasty groups with greater extent in knee arthroplasty.

Cited by 14 publications

References 20 publications

Cell Salvage in Hip and Knee Arthroplasty

Cell Salvage in Hip and Knee Arthroplasty

Protocol-Based Arthroplasty: Less Is More

Application of postoperative autotransfusion in total joint arthroplasty reduces allogeneic blood requirements: a meta-analysis of randomized controlled trials

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