• D Strümper, E W G Weber, S Gielen-Wijffels, R Van Drumpt, S Bulstra, R Slappendel, M E Durieux, and M A E Marcus.
• Department of Anesthesiology, University Hospital Maastricht, the Netherlands.
• Transfusion. 2004 Nov 1;44(11):1567-71.

BackgroundTotal knee arthroplasty (TKA) or total hip arthroplasty (THA) regularly results in postoperative requirement of blood transfusion. Because of the disadvantages of allogeneic blood transfusion (ABT) such as the risk of transfusion-associated infections, incompatibility-related transfusion fatalities, or immunomodulatory effects, a continuing effort to reduce allogeneic blood transfusion is important. For this purpose, the effect of reinfusion of drain blood, via a postoperative wound drainage and reinfusion system, on the need for allogeneic blood transfusion was evaluated.Study Design And MethodsUsing a prospective observational quality assessment design, we compared 135 patients scheduled for TKA or THA with a historic group of 96 patients. In the study group the Bellovac ABT autotransfusion system was used. The shed blood was returned either when 500 mL were collected or at most 6 hours after surgery. Compared were the preoperative, postoperative, and discharge hemoglobin, as well as the number of allogeneic blood transfusions.ResultsThere were no statistical differences between preoperative, postoperative, and discharge hemoglobin levels. Autologous transfusion reduced the number of patients receiving ABT overall from 35 percent (control) to 22 percent (study). The decrease of allogeneic transfusion requirement was most significant after TKA: from 18 percent to 6 percent (p < 0.001).ConclusionWe conclude that the Bellovac ABT device reduces allogeneic blood transfusions in TKA and THA.

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