Total knee arthroplasty is an elective procedure usually accompanied by significant blood loss requiring transfusion. Recently, medical colleagues and patients have become concerned about the immune reaction and the potential transmission of
infectious
diseases auch as AIDS and non-A & non-B Hepatitis via homologous banked blood. From march of 1993, we have used post-operative autotransfusion through the Orth-evac after total knee arthroplasty to minimize the need for the homologous tansfusion.
The
patients, who had not received the post-operative salvaged transfusion after TIR from November of 1990 to April of 1993, wer eallocated to Group I. The patients who had received the post operative salvaged blood via the Orth-evac from march of
1993
to
September of 1993 were allocated to group II. And each group included bilateral TKR(10 patients) and unilateral TKR(10 patients) respectively. Also, each group included cemented(10 patients) and cementles(10 patients) prosthesis. We evaluated the
efficacy and benefits of the post operative blood salvage system as comparsed to the homologous transfusion. The results of analysis were as follows.
1. The average shed blood amount in the first 2 days after TKR was 1373 ㎖at bilateral TKR and 742㎖at unilateral TKR in group. I, as compared to 1317 and 696 in group II.
2. In group I, the average transfused blood volume after TKR was 2.;7 pints of packed RBC at bilateral TKR and 2.2 pints at unilateral TKR. In group II, the average reinfused -blood volume was 593㎖at bilateral and 343㎖at unilat4erl.
3. In group II, 4 patients out of bilateral TKR(10 patients) requuired additional transfusion of average 2.5 pints of packed RBC and no patients at unilateral TKR.
4. The mean values for the detectable specimen of salvaged blood in 16 patients of group II were : WBC, 6580 : Hgb, 9.8g/㎗: Hct, 32.7% : Platelet, 70400.
5. The cement had no effects on the drainaged volume of blood after TKR.
6. No significant difference was noted in maximum pre and postoperative temperature between group I and II.
7. there were no complication like fat embolism, adult respiratory distress syndrome, disseminated intravascular coagulopathy, or sepsis except febrile reaction after transfusion.
|