Abstract

MACHADO, Sara et al. Impacto da re-infusão de sangue autólogo na necessidade de transfusão de sangue alogénico após Artroplastia Total do Joelho: Resultados de um ensaio clínico controlado e randomizado. Rev. Port. Ortop. Traum. [online]. 2017, vol.25, n.4, pp.283-291. ISSN 1646-2122.

Blood transfusion prevalence after knee arthroplasty ranges from 20 to 50%. The allogeneic red cell concentrate is expensive, scarce and potentially associated with several complications. Our aim was to evaluate the safety of the post-operative autologous blood salvage systems use and its efficacy in reducing the needs for allogeneic blood transfusion. 40 patients were selected. One group (A) underwent a post-operative autologous blood salvage system placement and other group (B) used a conventional pos-operative drainage system. The population showed normal distribution for age, body mass index and preoperative hemoglobin. In group A, the mean post-operative hemoglobin 2 hours and 24 hours after the end of blood reinfusion was 12 and 11.8 g/dl respectively. In group B the post-operative hemoglobin at 24 hours was 9.4 g/dl, corresponding to a post-operative hemoglobin decrease of 2 ± 1.1 g/dl and 3.7 ± 3 g/dl respectively. In group A no patient needed additional support transfusion. 7 of 20 patients (35%) of the group B patients received at least one allogeniec blood unit. We found a statistically significant difference (p = 0.034) between group A and group B for transfusion requirements after t-Student's t test application for for two independent samples. No complications were associated with re-infusion of the autologous blood. The reinfusion of autologous blood recovered after total knee arthroplasty is a safe and economically favorable option and can reduce the need for blood transfusion, thereby reducing the complications of allogeneic blood transfusion and allowing to face the increasing scarcity of donor blood supply.

Keywords : Arthroplasty; knee; blood; autologous; salvage; transfusion.

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