Application of postoperative autotransfusion in total joint arthroplasty reduces allogeneic blood requirements: a meta-analysis of randomized controlled trials

• Published in: BMC musculoskeletal disorders 2017-09, Vol.18 (1), p.378-378, Article 378
• Main Authors: Ji, Weiping, Lin, Xianfeng, Zhang, Ruoxia, Tang, Pan, Mo, Jian, Teng, Xinyi, Fan, Qiuping, Wang, Bo, Fan, Shunwu, Zhang, Jianfeng, Chen, Shuai, Huang, Kangmao
• Format: Article
• Language: English
• Subjects: Arthroplasty (knee); Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - trends; Arthroplasty, Replacement, Knee - adverse effects; Arthroplasty, Replacement, Knee - trends; Autologous blood transfusion; Autotransfusion; Blood & organ donations; Blood Loss, Surgical - prevention & control; Blood transfusion; Blood Transfusion - methods; Blood Transfusion - trends; Blood Transfusion, Autologous - methods; Blood Transfusion, Autologous - trends; Blood transfusions; Bone surgery; Clinical trials; Collaboration; Handbooks; Hip; Hip joint; Hip replacement arthroplasty; Humans; Infections; Intervention; Joint surgery; Knee; Knee replacement arthroplasty; Meta-analysis; Methods; Musculoskeletal diseases; Patient outcomes; Patients; Physiological aspects; Postoperative autotransfusion; Randomized Controlled Trials as Topic - methods; Risk assessment; Suctioning; Total hip arthroplasty; Total knee arthroplasty; Transplantation, Homologous; Trauma; Wound drainage
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-017-1710-2

Total joint arthroplasty is associated with significant blood loss and often requires blood transfusion. However, allogeneic blood transfusion (ABT) may lead to severe problems, such as immunoreaction and infection. Postoperative autotransfusion, an alternative to ABT, is controversial. We conducted a meta-analysis to evaluate the ability of postoperative autotransfusion to reduce the need for ABT following total knee arthroplasty (TKA) and total hip arthroplasty (THA). Systematic literature searches for randomized controlled trials were performed using PubMed, Embase, and the Cochrane Library until February 2016. Relative risks (RRs) and weighted mean differences with 95% confidence intervals (CIs) were calculated using fixed-effect or random-effect models; we also evaluated publication bias and heterogeneity. Seventeen trials with a total of 2314 patients were included in the meta-analysis. The pooled RRs of ABT rate between autotransfusion and the regular drainage/no drainage groups for TKA and THA were 0.446 (95% CI = 0.287, 0.693; p