Do autologous blood transfusion systems reduce allogeneic blood transfusion in total knee arthroplasty?

L.T. Medical College, Sion, Mumbai, India; Department of Orthopedics, Pramukswami Medical College, Anand, Gujrat, India; D.Y. Patil Medical College, Mumbai, India; Department of Orthopedics, National University Hospital, Singapore, Singapore; K.M. Nallasamy Hospital, Erode, Tamil Naidu, India; Department of Orthopedics, National University Hospital, Singapore, Singapore; J.J. Hospital, Mumbai, India.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the Esska. 2016;25((9):):2957-2966
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Abstract
PURPOSE To study whether autologus blood transfusion systems reduce the requirement of allogneic blood transfusion in patients undergoing total knee arthroplasty. METHODS A comprehensive search of the published literature with PubMed, Scopus and Science direct database was performed. The following search terms were used: (total knee replacement) OR (total knee arthroplasty) OR (TKA) AND (blood transfusion) OR (autologous transfusion) OR (autologous transfusion system). Using search syntax, a total of 748 search results were obtained (79 from PubMed, 586 from Science direct and 83 from Scopus). Twenty-one randomized control trials were included for this meta-analysis. RESULTS The allogenic transfusion rate in autologus blood transfusion (study) group was significantly lower than the control group (28.4 and 53.5 %, respectively) (p value 0.0001, Relative risk: 0.5). The median units of allogenic blood transfused in study control group and control group were 0.1 (0.1-3.0) and 1.3 (0.3-2.6), respectively. The median hospital stay in study group was 9 (6.7-15.6) days and control group was 8.7 (6.6-16.7) days. The median cost incurred for blood transfusion per patient in study and control groups was 175 (85.7-260) and 254.7 (235-300) euros, respectively. CONCLUSION This meta-analysis demonstrates that the use of auto-transfusion systems is a cost-effective method to reduce the need for and quantity of allogenic transfusion in elective total knee arthroplasty. LEVEL OF EVIDENCE Level I.
Study details
Study Design : Systematic Review
Language : English
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine