Elective orthopaedic surgery is particularly suggested for an autologous preoperative blood donor program because it is generally forseeable and routinely requires transfusion. We report a retrospective 3-year analysis of transfusion requirement in orthopaedic surgical patients undergoing hip and knee replacement in an Orthopaedic Unit where predeposit has been employed as an autologous blood transfusion strategy. We analyse the effectiveness and utilization of autologous blood transfusion, homologous blood risk exposure, relevant factors for a preoperative blood donor program. 580 patients (182 males and 398 females) who underwent total joint replacement were studied for blood requirement during surgery unit the 6th postoperative day. We divided patients into two groups: A) autologous blood patients (258) and B) nonautologous blood patients (322). Eighty-seven per cent of the patients received transfusion: homologous blood risk exposure was 11% in group A and 91% in group B. Over a 3-year period, group A-patiens increased progressively (from 24% to 44%) and an adequate equilibrium was obtained between predeposited units and autologous transfused units. Surgical technique, homogeneous surgeons and transfusionist's care influenced the autologous blood program's success. Too many patients (55%) didn't use autologous blood donation. Increasing care in autologous blood donation and legal concerns provided to modify practice style on transfusion decision making. Nowaday homologous blood is less required and much more avoided. Our goal consists in eliminating the need for homologous blood. Orthopaedics, anestesiologists and transfusionists have to provide further opportunities such as intra and postoperative salvage and erythropoietin therapy.
|Translated title of the contribution||Effectiveness and troubles of autologous blood transfusion in knee and hip replacement surgery|
|Number of pages||6|
|Journal||Minerva Ortopedica e Traumatologica|
|Publication status||Published - 1994|
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