Abstract
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are invariably associated with substantial blood loss during or after surgery. To avoid allogeneic blood transfusion, autologous blood is obtained preoperatively when THA or TKA is scheduled. To determine the appropriate amount of autologous blood to be taken before surgery, we investigated the extent of intraoperative and postoperative blood loss, and the proportion of cases requiring allogeneic transfusion.
Eighty-eight primary THAs and 92 primary TKAs were included in this study. For 65 of the THAs (73.9%) and 67 of the TKAs (72.8%), autologous blood was donated according to the guidelines of the Japanese Society of Autologous Blood Transfusion. The mean volume of total blood loss was 1,120ml in the THA group and 460ml in the TKA group. Allogeneic transfusion was performed in 28 of the THAs (31.8%) and 21 of the TKAs (22.8%). The rate of usage of postoperative allogeneic transfusion decreased in accordance with the increase of the amount of autologous blood that had been stored.
Storage of more than 600ml and 400ml of autologous blood for THA and TKA, respectively, is sufficient for avoiding allogeneic blood transfusion. Further effort is required to reduce intra- and postoperative blood loss in patients who cannot donate a sufficient amount of autologous blood.
