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 Release 22.0, Sept. 2008
 
Chapter : ch5. Transfusion Medicine Section : Estimation of Blood Loss and Prediction of Blood Transfusion Needs
  Identification of Total Joint Arthroplasties with Very Low Need for Perioperative Blood Transfusion and for Autologous Blood Collection

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Overview :

Certain patients undergoing total joint arthroplasty procedures have a very low chance of receiving a blood transfusion in the perioperative period. These patients may not need to donate autologous blood.

 

Rationale:

(1) The National Heart, Lung and Blood Institute Expert Panel on the Use of Autologous Blood has recommended that patients with < 10% chance of needing a perioperative transfusion should not be encouraged to donate autologous blood.

(2) A large percentage (56% of units in the study population) of the autologous products are discarded.

 

Factors with an increased risk for blood transfusion:

(1) revision knee or hip procedure

(2) one-stage bilateral primary knee replacement

(3) initial hemoglobin < 130 g/L

(4) age >= 65

 

Groups with Very Low Chance of Perioperative Transfusion

 

Group 1:

(1) hemoglobin >= 150 g/L

(2) unilateral primary arthroplasty

 

Group 2:

(1) hemoglobin 130 – 150 g/L

(2) age < 65 years of age

(3) unilateral primary arthroplasty

 

NOTE: These findings are similar to those described above in 05.01.02.

 

  References:

Hatzidakis AM, Mendlick RM, et al. Preoperative autologous donation for total joint arthroplasty. J Bone Joint Surg. 2000; 82-A: 89100.

 

 

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