Porovnání efektivnosti pooperačního retransfuzního systému s perioperačním autotransfuzním systémem při implantacích totálních endoprotéz kolenního kloubu
| Title in English | Post-Operative Retransfusion and Intra-Operative Autotransfusion Systems in Total Knee Arthroplasty. A Comparison of their Efficacy |
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| Authors | |
| Year of publication | 2012 |
| Type | Article in Periodical |
| Magazine / Source | Acta chirurgiae orthopaedicae et traumatologiae čechoslovaca |
| MU Faculty or unit | |
| Citation | |
| Web | http://www.achot.cz/detail.php?stat=555 |
| Field | Surgery incl. transplantology |
| Keywords | post-operative retransfusion system; intra-operative autotransfusion system; total knee arthroplasty |
| Description | PURPOSE OF THE STUDY: The aim of the study was to compare the effect of post-operative retransfusion with that of intra-operative autotransfusion in non-anaemic patients undergoing total knee arthroplasty (TKA). RESULTS: Of the 129 patients with post-operative retransfusion, 25 received one or more allogeneic blood transfusions due to the haemoglobin level below 90g/l and symptoms of anaemia. The average haemoglobin level was 136 g/l (range, 111 to 159 g/l) one day before surgery and 107 g/l (range, 81 to 143 g/l) on the 2nd post-operative day. A single allogeneic blood transfusion was administered to 12 patients and two were necessary in 13 patients. The average blood volume returned to the patient through the post-operative retransfusion system was 725.3 ml (range, 250 to 1 300 ml). Of the 142 patients with intra-operative autotransfusion, 11 patients required blood transfusion in the post-operative period, with seven receiving one and four receiving two transfusions. The average haemoglobin level was 135 g/l (range, 110 to 161 g/l) one day before surgery and 107 g/l (range, 85 to 130 g/l) two days after it. The average volume of erythrocyte mass returned to the patient through the intra-operative autotransfusion system was 330.7 ml (range, 0 to 850 ml). No allergic, pyretic or other reaction or complication was recorded in either group. No early TKA infection occurred. CONCLUSIONS: The use of either of these systems has proved to be a simple and safe method of reducing the need of allogeneic blood transfusion in the TKA procedure. While the post-operative retransfusion system facilitates the return of drained blood only, the more efficient "cell-saver" technology collects blood shed during both intra- and post-operative periods and allows for erythrocyte mass retransfusion during and after surgery. Since the administration of allogeneic blood was required in less than 10% of the patients receiving intra-operative autotransfusion, this system was adopted as a more efficient method in routine TKA procedures. |