CELL SALVAGE AUTO TRANSFUSION IN TOTAL KNEE REPLACEMENT SURGERY

We conducted a prospective, randomized study to assess the impact of c ell salvage, auto transfusion on the requirements for allogeneic blood for patients undergoing a total knee replacement (TKR). One hundred c onsecutive TKR patients were randomly allocated to receive either auto logous blood (using cell salvage) or an allogeneic blood transfusion a s necessary. Patients allocated to the autologous group were rescued w ith allogeneic blood if the postoperative haemoglobin fell below 9 g d L(-1). Forty-two (84%) of 50 patients in the autologous group required no supplementary blood transfusion. Forty (80%) of 50 patients alloca ted to receive allogeneic blood required transfusion. There were no de trimental effects of autologous blood transfusion. We conclude that au tologous blood transfusion, using the cell saver system, is a safe and effective method of reducing the need for allogeneic blood transfusio n and, in doing so, reduces the risk of transmission of infections ass ociated with allogeneic blood transfusion, whilst decreasing demand on precious allogeneic blood reserves.