Review Article

HSS Journal

, Volume 6, Issue 2, pp 190-198

Alternative Procedures for Reducing Allogeneic Blood Transfusion in Elective Orthopedic Surgery

  • Kathrin KleinertAffiliated withDepartment of Orthopaedics, Balgrist University Hospital, University of Zurich
  • , Oliver M. TheusingerAffiliated withInstitute of Anaesthesiology, University Hospital Zurich, University of Zurich
  • , Johannes NuernbergAffiliated withInstitute of Anaesthesiology, University Hospital Zurich, University of Zurich
  • , Clément M. L. WernerAffiliated withDepartment of Orthopaedics, Balgrist University Hospital, University of ZurichDivision of Trauma Surgery, Department of Surgery, University Hospital Zurich Email author 

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Abstract

Perioperative blood loss is a major problem in elective orthopedic surgery. Allogeneic transfusion is the standard treatment for perioperative blood loss resulting in low postoperative hemoglobin, but it has a number of well-recognized risks, complications, and costs. Alternatives to allogeneic blood transfusion include preoperative autologous donation and intraoperative salvage with postoperative autotransfusion. Orthopedic surgeons are often unaware of the different pre- and intraoperative possibilities of reducing blood loss and leave the management of coagulation and use of blood products completely to the anesthesiologists. The goal of this review is to compare alternatives to allogeneic blood transfusion from an orthopedic and anesthesia point of view focusing on estimated costs and acceptance by both parties.

Keywords

allogeneic blood transfusion blood loss elective orthopedic surgery autologous blood transfusion predonation hemodilution EPO iv iron fibrin sealant platelet gel