Allogeneic blood transfusion reduction by risk-based protocol in total joint arthroplasty

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
Saifudin RashiqBarry Finegan

Abstract

To evaluate the effect of a preoperative protocol that triages patients awaiting total joint arthroplasty to one of four strategies designed to mitigate the risk of allogeneic blood transfusion (ABT) based on a priori transfusion risk on perioperative exposure to allogeneic blood. We compared the transfusion experiences of a historical control series of 160 subjects with a study group of 160 subjects treated by protocol. Protocol subjects with hemoglobin (Hb) 100-129 g.L(-1) were given erythropoietin, dosed by weight. Subjects with Hb 130-139 g.L(-1) underwent preoperative autologous blood harvest and perioperative re-infusion as deemed clinically necessary. Subjects with Hb >139 g.L(-1) received no special intervention, unless they were aged >70 yr and weighed < 70 kg, in which case they received oral iron and folate supplementation. The relative risk of ABT in the Study group was 0.68 (95% confidence interval 0.54-0.85). The Control group received 104 units of allogeneic blood and the Study group received 35 units (P = 0.0007). These differences cannot be explained by differences in transfusion risk or autologous units transfused. There was no worsening of anemia or its consequences in the Study group. A simple protocol based...Continue Reading

References

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Jul 15, 2004·The Journal of Bone and Joint Surgery. American Volume·Jeffery L PiersonDonald R Earles
Sep 24, 2004·Anesthesia and Analgesia·Saifudin RashiqBarry A Finegan
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Oct 16, 2007·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·James Edward PaulLehana Thabane
Sep 2, 2008·The Journal of Bone and Joint Surgery. British Volume·R Lemaire

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Citations

Oct 25, 2011·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Marco PavesiFilippo Randelli
Feb 23, 2018·Geriatric Orthopaedic Surgery & Rehabilitation·Christopher P ChildersMelinda Maggard-Gibbons
Aug 9, 2017·Clinical Orthopaedics and Related Research·Mitchell R KlementThorsten M Seyler
Mar 27, 2013·International Journal of Immunopathology and Pharmacology·F RandelliG Randelli

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