Effect of Preoperative Autologous Blood Donation Coupled With Fluid Resuscitation on Transfusion Requirements Following Orthopedic Surgery

Diane Hazel, Murray Bern, James Bono, Donald Reilly, Claire Robbins


Background: Preoperative auto-blood donation has been shown to increase the likelihood of developing postoperative anemia following orthopedic surgery. This study was to assess the additive effect of intraoperative plus postoperative fluid resuscitation upon the relationship between preoperative donation and the frequency of postoperative transfusion.

Methods: In this retrospective, single institution case-controlled study, hemoglobin levels, fluid administration, and incidence of transfusion were reviewed among 182 patients (91 donated blood preoperatively and 91 did not) undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA).

Results: Thirty-two (35.2%) donors and 18 (19.8%) non-donors received transfusion for adjusted risk of 2.817 (1.301 - 6.100) among donors versus non-donors. Donors are more affected by the hemodilution effects associated with fluid infusion and are transfused earlier and more frequently than non-donors.

Conclusion: Preoperative autologous donation and fluid administration increase the risk for receiving postoperative transfusion.

J Hematol. 2015;4(2):157-163
doi: http://dx.doi.org/10.14740/jh208w



Hemodilution; Transfusion; Hip replacement; Knee replacement; Autologous donation

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