To evaluate the quality of shed blood postoperatively after total knee
arthroplasty (TKA), the safety of autotransfusion, and to minimize ho
mologous transfusion, the Autovac system was used for reinfusion of wh
ole blood following cemented TKA. The system was used in 50 consecutiv
e patients who were reinfused an average of 420 cc of whole blood. Twe
nty-five patients had a calcium binding resin anticoagulant within the
collection canister, A second group of 25 patients had 40 cc of acid
citrate dextrose anticoagulate (ACD-A) in the collection canister as a
n anticoagulant, Fifteen hematologic parameters were measured during f
ive time periods, Each study group was compared to a control group of
25 TKAs with a standard drain, The clinical safety of auto-transfusion
with ACD-A was proven, Blood collected in the calcium binding resin h
ad a statistically significant higher hemoglobin (P<.05), plasma-free
hemoglobin (P<.05), fibrin split products (P<.05), and a different whi
te blood cell differential.