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  • Title: [An Analysis of Autologous Blood Transfusion in Major Orthopedic Surgery : Our Experience with 2,262 Patients.].
    Author: Chikako T, Makoto F, Haruka I, Hironori I, Takashi E, Akiko S, Sojirou M, Yoshiaki T.
    Journal: Masui; 2016 Sep; 65(8):801-805. PubMed ID: 30351590.
    Abstract:
    BACKGROUND: Allogenic blood transfusion accompa- nies the risks of infection, allergic reaction, and immune suppression. We analyzed the patients having autolo- gous blood transfusion in major orthopedic surgery in our hospital. METHODS: We analyzed 2,262 patients scheduled for autologous transfusion for the last 22 years (from Sep- tember 1991 to September 2013) retrospectively. Autologous transfusion was scheduled alone or com- bined with two or three methods, that is, preoperative donation, acute hemodilution, or blood salvage, accord- ing to the type of surgery and intra- and post-opera- tive blood loss. RESULTS: Almost all the cases were major orthopedic surgeries, e. g., total hip arthroplasty (primary, unilat- eral THA, 1,281 patients, revision THA, 84 patients), total knee arthroplasty (primary TKA, 519 patients), rotational acetabular osteotomy and curved periace- tabular osteotomy (RAO and CPO, 145 patients), and scoliosis surgery (44 patients). For predonation, autolo- gous blood of 400-800 ml was obtained from all patients and supplemented with 400-800 ml of acute hemodilution during preoperative period and 200-400 ml of salvage during the intra- and post-operative period. As a result, 260 cases (11%) received allogenic blood transfusion, and 13 cases (0.5%) developed vasovagal reflex during drawing blood, and one patient died the day after drawing blood not related with predonation. CONCLUSIONS: The use of autologous transfusion would be useful for avoiding or reducing homologous transfusion requirements in scheduled orthopedic major surgeries.
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