Retransfusion of drained blood in total joint arthroplasty- does this reduce the requirement for a blood transfusion?

Retransfusion of drained blood in total joint arthroplasty- does this reduce the requirement for a blood transfusion?

Hooper, G

The purpose of this study was to establish whether retransfusion of blood collected in drains following total joint replacement was a safe and effective procedure. All patients undergoing a total joint arthroplasty, with no history of infection, between March and October 2001, were entered into the study. A single surgeon operated on all patients and no patient was excluded from the study. Informed consent was obtained and all blood drained into a recollection system within 6 hours of surgery was retransfused. A prospective protocol was filled out in all cases documenting the pre and postoperative haemoglobin, amount transfused and any extra transfusion requirements. A special note was made of any complications encountered during retransfusion. The results were then compared to previously known transfusion rates within the same hospitals.

There were 141 Total Joint Arthroplasties performed within the study period -12 were bilateral and 12 were revisions procedures. The average drainage was 655ml (60-3280ml) and the average amount of retransfused blood from the drains was 225ml (100-1822ml). There were a total of 9 (6.3%) subsequent blood transfusions. Four (3.8%) in primary and 5 (20.8%) in bilateral or revision procedures.

Transfusing patients with salvaged blood from the drains in total joint arthroplasty is a safe, reliable and cost effective practice, which significantly reduces the requirement for a subsequent blood transfusion. As a result of this study the Christchurch Orthopaedic Group has adopted a routine practise of retransfusing drained blood in all total joint arthroplasties.

G. Hooper, S. Winchester

Christchurch Orthopaedic Group, Christchurch.

Copyright British Editorial Society of Bone & Joint Surgery 2003

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