Re-transfusion of autologous blood from wound drains: the means for reducing tranfusion requirements in total knee arthroplasty


      The requirements for homologous blood transfusion in patients undergoing total knee replacements under tourniquet, before and after the introduction of autologous transfusion of blood collected from wound drains, are compared. In a control population of 93 patients undergoing total knee replacement, 67 required homologous transfusions of two units or more. In 160 patients who were re-transfused with blood from wound drains, only 30 required additional homologous transfusions. Re-transfusion of filtered drained blood reduces the need for homologous bank blood. This avoids the risks associated with donated blood and affords significant cost savings.


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        • Lotke P.A
        • Faralli V.J
        • Orenstein E.M
        • Ecker M.L
        Blood loss after total knee replacement. Effect of tourniquet release and continuous passive motion.
        J Bone Jt Surg Am. 1991; 73: 1037-1040
        • Sehat K.R
        • Evans R
        • Newman J.H
        How much blood is really lost in total knee arthroplasty? Correct blood loss management should take hidden loss into account.
        The Knee. 2000; 7: 151-155
        • Walker R.H
        Special report: Transfusion risks.
        Am J Clin Pathol. 1987; 88: 374-378
        • Tartter P.I
        Blood transfusion and infectious complications following colorectal cancer surgery.
        Br J Surg. 1988; 75: 789-792
        • Newman J.H
        • Bowers M
        • Murphy J
        The clinical advantages of autologous transfusion. A randomised controlled study after knee replacement.
        J Bone Jt Surg Br. 1997; 79: 630-632
        • Farris P.M
        • Ritter M.A
        • Keating E.M
        • Valeri C.R
        Unwashed filtered shed blood collected after knee and hip arthroplasties. A source of autologous blood cells.
        J Bone Jt Surg Am. 1991; 73: 1169-1177
        • Dalen T
        • Skak S
        • Thorsen K
        • Fredin H
        The efficacy and safety of blood re-infusion in avoiding homologous transfusion after total knee arthroplasty.
        Am J Knee Surg. 1996; 9: 117-120
        • Henderson M.S
        • Newman J.H
        • Hand G.C.R
        Blood loss following knee replacement surgery, use it don't lose it.
        The Knee. 1999; 6: 125-129
        • Groh G.I
        • Buchart P.K
        • Allen W.C
        A comparison of transfusion requirements after total knee arthroplasty using the Solcotrans auto transfusion system.
        J Arthroplasty. 1990; 5: 281-285
        • Han C.D
        • Shin P.E
        Post operative blood salvage and re-infusion after total joint arthroplasty.
        J Arthroplasty. 1997; 12: 511-516
        • Healy W.L
        • Kurtz S.R
        • Johnson C
        • et al.
        Evaluation of autologous shed blood for auto transfusion after orthopaedic surgery.
        Clin Orthop. 1994; 299: 53-59
        • Dalen T
        • Brostrom L.A
        • Engstrom K.G
        Autotransfusion after total knee arthroplasty. Effects on blood cells, plasma chemistry and whole blood rheology.
        J Arthroplasty. 1997; 12: 517-525
        • Hand G.C
        • Henderson M
        • Mace P
        • Sherif N
        • Newman J.H
        • Goldie D.J
        Methyl methacrylate levels in unwashed salvage blood following unilateral total knee arthroplasty.
        J Arthroplasty. 1998; 13: 576-579
        • Berman A.T
        • Levenberg R.J
        • Tropiano M.T
        • Parks B
        Post operative auto transfusion after total knee arthroplasty.
        Orthopaedics. 1996; 19: 15-22
        • Duncan S.E
        • Edward W.H
        • Dale W.A
        Caution regarding autotransfusion.
        Surgery. 1974; 76: 1024-1030
        • Southern E.P
        • Huo M.H
        • Mehta J.R
        • Keggi K.J
        Unwashed wound drainage blood. What are we giving our patients?.
        Clin Orthop. 1995; 320: 235-246
        • Blevins F.T
        • Shaw B
        • Valeri C.R
        • Kasser J
        • Hall J
        Reinfusion of shed blood after orthopaedic procedures in children and adolescents.
        J Bone Jt Surg Am. 1993; 75: 363-371
        • Breakwell L.M
        • Getty C.J.M
        • Dobson P
        The efficacy of autologous blood transfusion in bilateral total knee arthroplasty.
        The Knee. 2000; 7: 145-147