The results of intraoperative autotransfusion in patients undergoing major orthopaedic surgery

Abstract

Peroperative hemorrhage associated with major orthopaedic surgery can become life threatening. Homologous bank blood transfusion can replace the volume loss but it has serious disadvantages such as transmission of viral agents, insufficient platelet count and transfusion reactions. Hypotensive anesthesia, predeposited autologous blood transfusion and intraoperative autotransfusion are used to reduce these disadvantages. This study evaluates the results of 400 patients who had major orthopaedic intervention in our clinic between June 1991 and April 1995. Seventy-one patients had hip surgery while 329 patients had spinal surgery. The autotransfusion unit saved an average of 848.9 ± 133.8 cc of blood and an average of 1.8 ± 1.1 units of saved blood is transfused. None of these patients needed homologous blood transfusion. Hundred patients who had spinal surgery at the same period are used as a control group. The control group required an average of 3.2 ± 2.1 units of bank blood. Pre and postoperative hematocrit values revealed a statistically significant difference between the autotransfusion group and the homologous transfusion group (p<0.05). This study suggests that intraoperative autotransfusion prevents the decrease in hematocrit values while reducing the need for bank blood transfusion and avoiding the risk of transmission of viral infections.