Autologous bleed transfusion in total knee replacement surgery

We compared allogeneic blood usage for two groups of patients undergoing to tal knee replacement surgery (TKR). Patients were randomized to receive eit her their post-operative wound drainage as an autotransfusion (n=115) after processing or to have this wound drainage discarded (n=116). Allogeneic bl ood was transfused in patients of either group whose haemoglobin fell below 9 g dl(-1). Only 7% of patients in the autotransfusion group required an a llogeneic transfusion compared with 28% in the control group (P <0.001). Th ere was no hospital mortality and only 3% mortality from all causes at the study completion, which spanned 6 months to 3 yr. There was a higher incide nce of infection requiring intervention in the allogeneic group (P <0.036). Total patient costs were pound 113 greater in the autotransfusion group. W e conclude that in this type of surgery post-operative cell salvage is a sa fe and effective method for reducing allogeneic blood use.