HSS Journal

, Volume 6, Issue 2, pp 190–198 | Cite as

Alternative Procedures for Reducing Allogeneic Blood Transfusion in Elective Orthopedic Surgery

  • Kathrin Kleinert
  • Oliver M. Theusinger
  • Johannes Nuernberg
  • Clément M. L. WernerEmail author
Review Article


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.


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


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Copyright information

© Hospital for Special Surgery 2009

Authors and Affiliations

  • Kathrin Kleinert
    • 1
  • Oliver M. Theusinger
    • 2
  • Johannes Nuernberg
    • 2
  • Clément M. L. Werner
    • 1
    • 3
    Email author
  1. 1.Department of Orthopaedics, Balgrist University HospitalUniversity of ZurichZurichSwitzerland
  2. 2.Institute of Anaesthesiology, University Hospital ZurichUniversity of ZurichZurichSwitzerland
  3. 3.Division of Trauma Surgery, Department of SurgeryUniversity Hospital ZurichZurichSwitzerland

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