Efficacy of preoperative autologous blood storage in one-stage bilateral total knee arthroplasty.

Abstract

BACKGROUND:

One-stage bilateral total knee arthroplasty (TKA) has the advantages of a single hospital stay, shorter rehabilitation, and reduced financial burden on patients. However, perioperative bleeding is greater with one-stage bilateral TKA than with unilateral TKA and is more likely to require allogeneic blood transfusion. At our hospital, we normally store autologous blood about 1 month before surgery to reduce the need for allogeneic blood transfusion and avoid its adverse reactions as much as possible. The purpose of this study was to determine the efficacy of preoperative autologous blood storage for patients undergoing one-stage bilateral TKA.

METHODS:

We retrospectively examined the allogeneic blood transfusion avoidance rate and the perioperative decrease in hemoglobin (Hb) level in 166 patients according to whether or not they had preoperative autologous blood stored. The patients for whom blood was stored were then subdivided according to whether the amount of blood stored was 400 mL or 200 mL.

RESULTS:

Excluding allogeneic transfusion cases, the mean perioperative decrease in Hb was significantly lower in the patients with stored blood than in those without stored blood (3.5 g/dL vs 4.4 g/dL, p < 0.001). The allogeneic blood transfusion avoidance rate was significantly higher in the group with stored blood (98.5% vs 86.7%, p < 0.01). In the group with stored blood, the transfusion avoidance rate was higher, but not significantly, in the subgroup with 400 mL of blood stored than in those with 200 mL of blood stored (100% vs 97.5%) and the mean perioperative decrease in Hb was 3.5 g/dL in both blood storage volume groups.

CONCLUSIONS:

Preoperative autologous blood storage can help increase the likelihood of avoiding allogeneic blood transfusion in patients undergoing one-stage bilateral TKA.

• Authors: Masaru Nakamura, Shunji Nakano, Ryosuke Sato, Kenji Kondo, Hitoshi Goto, Haruhiko Yoshinari, Tateaki Shimakawa, Tetsuya Enishi, Shinji Yoshioka, Koichi Sairyo
• Journal: Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association (J Orthop Sci) Vol. 27 Issue 3 Pg. 648-651 (May 2022) ISSN: 1436-2023 [Electronic] Japan
• PMID: 35370041 (Publication Type: Journal Article)
• Copyright: Copyright © 2022. Published by Elsevier B.V.

Chemical References

• Hemoglobins

Topics

• Arthroplasty, Replacement, Knee (adverse effects)
• Blood Loss, Surgical
• Blood Preservation
• Blood Transfusion
• Hematopoietic Stem Cell Transplantation
• Hemoglobins
• Humans
• Retrospective Studies