EVALUATION OF AUTOLOGOUS SHED BLOOD FOR AUTOTRANSFUSION AFTER ORTHOPEDIC-SURGERY

Autologous shed blood for autotransfusion was evaluated at four medica l centers in a prospective randomized study. One hundred twenty-eight patients were studied after hip replacement, knee replacement, or spin e fusion. The efficacy of autologous shed blood in reducing homologous transfusion was evaluated. The relative risk of transfusion with homo logous blood was 0.4 in patients who received shed blood compared with patients who did not receive shed blood. The reinfusion of shed blood reduced the requirement for homologous blood by 60%. Two filter syste ms were evaluated in reinfusing autologous shed blood. The Pall RC100 filter appeared to be more effective than the Pall 40-mu screen filter in removing fat particles and white blood cells. No significant clini cal abnormalities were discovered after autotransfusion with autologou s shed blood. Evaluation of clotting studies showed no significant dif ferences between patients who received shed blood and patients who rec eived liquid-preserved red blood cells. These data indicate that unwas hed autologous shed blood from orthopaedic wound drainage is a safe an d effective substitute for transfusion of autologous predonated blood or homologous liquid-preserved red blood cells.