ALLOGENEIC BLOOD-STORING PROGRAMME IN TOTAL HIP REPLACEMENT

Abstract

Introduction and purpose: Methods are needed to store blood for scheduled surgery with high transfusion requirements. We evaluated the transfusion requirements in patients undergoing surgery for total hip replacement (THR) and the results of the autotransfusion programme.

Materials and methods: We assessed 211 patients who underwent primary or secondary THR between November 1999 and November 2004 and were included in the blood-storing programme. The variables analysed were: sex, age, operation, start of weight bearing, hospital stay, units extracted and transfused, basal hemoglobin and follow-up and use of allogeneic blood.

Results: 177 patients entered the programme, 14 on EPO and 13 with no blood-storing procedure. The mean age was 61.8. The male/female ratio was 1.5, and 109 patients (52%) were transfused. We found differences (p< 0.01) between non-transfused and transfused patients in relation to their basal Hb (14.4 vs 13.7), start of weight bearing (4.6 vs 9.6 days) and hospital stay (9.1 vs 10.3 days). Of the patients in the autotransfusion programme, 58% (103) required transfusion and used 54% of the units extracted. Seven percent (13) required allogeneic blood. Of 138 patients with primary THR, 80 were transfused – 83% women and 36% men (p< 0.001). Of the 39 revision THRs, 23 patients were transfused with no differences between the sexes. Overall, 31 units of allogeneic red cell concentrate were used, 192 autologous. 87 patients required 2 units, 15 patients 1 unit and one patient 3 units.

Conclusions: The autotransfusion programme for THR patients is adequate for storing allogeneic blood. Nevertheless, it should be included in this protocol via an individualised interdisciplinary programme.