AUTOLOGOUS BLOOD-TRANSFUSION IN HIP-REPLACEMENT - NO EFFECT ON BLOOD-LOSS BUT LESS INCREASE OF PLASMINOGEN-ACTIVATOR INHIBITOR IN A RANDOMIZED SERIES OF 80 PATIENTS

80 patients underwent total hip replacement (THR) for primary coxarthr osis. In a randomized study, half of them donated 2 units of blood bef ore operation, One unit was collected 4 weeks and one 2 weeks before t he scheduled THR. All except 1 patient tolerated the predonations well , Total blood losses were similar in both groups. Additional bank bloo d was given in 7/38 in the predonation group, compared to 29/40 in the control group, Hemostatic parameters were studied in 10 consecutive p atients in each group, Plasminogen activator inhibitor 1 (PAI-1), a po ssible risk parameter for thromboembolism, was significantly more incr eased postoperatively in the control group, which received only homolo gous blood. Platelet count, prothrombin complex, antithrombin III and von Willebrand factor antigen were significantly reduced and C reactiv e protein increased after surgery in both groups. We recommend predona tion of 2 autologous units before a primary THR. In most cases, such p redonation makes homologous blood transfusion unnecessary. The use of predonated blood causes no reduction of blood loss in THRs, but the in crease in PAI-I seen after homologous transfusions is avoided.