Blood Transfusion in Knee Arthroplasty

Abstract

Orthopedic surgery is one of most blood-consuming surgical specialties since it is associated with a significant preoperative hemorrhage requiring frequent allogeneic blood transfusions. A special mention needs to be done to hip and knee arthroplasty, complex rachis arthrodesis and tumor-pathology removal. The intervention on older and higher-risk patients has raised the demand on allogeneic blood to such levels that even Blood Banks are unable to attend. Besides the high cost, using allogeneic blood has its risks, such as immunosuppression, patient’s wrong identification, transfusion reactions or the possibility of infectious disease transmission. This imbalance between blood demand and availability, together with the awareness about potential risks of blood transfusions and the continuous advances both in technology and pharmaceutics, should lead us to extreme changes in transfusion politics; developing a series of therapeutic measures to reduce blood transfusion to minimum, leaving its use only when it is strictly necessary, especially in scheduled surgery