EFFICACY AND ECONONOMICS OF POSTOPERATIVE BLOOD SALVAGE IN PATIENTS UNDERGOING ELECTIVE PRIMARY TOTAL HIP REPLACEMENT

Abstract

The purpose of this study was to determine the effect of the use of a system to retransfuse salvaged drainage blood in patients undergoing primary THR with the aim of avoiding the significant risks that allogeneic blood transfusion poses to the patient. This was a retrospective cohort study where records of 109 patients undergoing elective THR following the introduction of an autologous retransfusion system at the institution were compared with a cohort of similar patients who underwent the same procedure prior to the introduction of the autologous system. The two groups were matched for age, surgeon, approach and technique and the results were subjected to statistical analysis. The use of a system to retransfuse postoperative salvage drainage blood, without concomitant use of predonation or intraoperative blood salvage, significantly reduced the need for allogeneic blood transfusion from 30% to 9%(p< 0.001). Patients who received salvaged blood also had a significantly smaller haemoglobin drop (Difference 0.56g/dL p=0.001) in the perioperative period, even though the preoperative haemoglobin level was not significantly different in the two cohorts. The overall cost of using the retransfusion system was similar to that of routine vacuum drainage when the savings of reduced allogeneic blood transfusion were considered. In conclusion the retransfusion of postoperative salvage drainage blood is a simple, effective and economical way of providing autologous blood for patients undergoing primary THR