Who Needs Autologous Blood Donation in Joint Replacement?

Javad Parvizi; Sonia Chaudhry; Mohammad R Rasouli; Luis Pulido; Ashish Joshi; Jay H Herman; Richard H Rothman

doi:10.1055/s-0031-1275404

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2011; 24(1): 025-032
DOI: 10.1055/s-0031-1275404

ORIGINAL ARTICLE

Who Needs Autologous Blood Donation in Joint Replacement?

Javad Parvizi¹ , Sonia Chaudhry¹ , Mohammad R. Rasouli¹ , Luis Pulido¹ , Ashish Joshi¹ , Jay H. Herman¹ , Richard H. Rothman¹

¹Department of Orthopaedics, Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania

Abstract

ABSTRACT

Conflicting results are available about the efficacy of routine preoperative autologous donation (PAD) in reducing allogenic blood transfusion during total joint arthroplasty (TJA). This study aimed to determine if PAD is effective in reducing the need for allogenic transfusion after TJA. For this retrospective study, data on 409 patients who received total knee arthroplasty (TKA) and 513 who underwent total hip arthroplasty (THA) from January to June 2005 were evaluated. It is our institutional policy to offer preoperative donation to all patients. Based on patient decision, preoperative hemoglobin, and other factors, PAD may or may not take place. Five hundred forty-six (61%) patients donated on average 1.3 units (range, 1 to 2) of blood. Autologous and allogenic transfusions were respectively performed in 91% (514 patients) and 24% of our cohort. The rate of allogenic transfusion after TKA was lower in the PAD group at 21% versus 27% among the nondonors, although it was not statistically significant (p = 0.10). The allogenic transfusion rate after THA was significantly lower among autologous donors (16% versus 34%, p = 0.003). Advanced age, lower body mass index, simultaneous bilateral arthroplasty, and lower preoperative hemoglobin were independently associated with increased allogenic blood transfusion. PAD seems to be effective in reducing allogenic transfusions after THA but not TKA.

KEYWORDS

Preoperative autologous donation - allogenic transfusion - total joint arthroplasty - risk factors

Full Text

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Javad ParviziM.D.

Department of Orthopaedics, Rothman Institute at Thomas Jefferson University, 925 Chestnut Street

5th Floor, Philadelphia, PA 19107

Email: parvj@aol.com