BLOOD TRANSFUSION FOR TOTAL KNEE REPLACEMENT

Auto transfusion

We do everything we can to minimize blood loss during and after surgery.   

Knee replacement patients rarely require to be transfused with blood after the operation. Because a tourniquet is used during the surgery,  the blood loss occurs after the operation is over due to oozing of blood from cut surfaces of the bone.

Drains are used to collect this blood and now with modern systems, this collected blood can be returned to you in your drip (auto transfusion). This does not work in all cases and may not be used at times.   Nevertheless this has dramatically reduced the need for blood transfusions.

First time knee replacements rarely require transfusion of blood.  Revision knee replacement may need 2 to 3 units or more.

Constavac Blood Conservation System

Autologous Blood

The advent of AIDS has highlighted the risks associated with using other peoples’ blood.

You may donate your own blood prior to knee surgery because of the other risks associated with transfusion.  The blood is stored and given back to you at the time of the operation (see “Autologous Donation” below).

We usually do not suggest Autologous Donations with first time knee replacements for a single knee as it is usually not needed and may be wasted. Nevertheless for bilateral knee replacements (when you have both knees done at once) or revision knee replacements, autologous donations may be advised

Autologous Blood is blood donated by you and later given back to you. Usually two units of blood are taken from you at approximately 1-week intervals in the month prior to surgery.

There is no age requirement for storing your own blood, and no specific weight requirement.  However, if you are anemic (Hemoglobin under 11gm/dl) we cannot take your blood.   There are also some medical conditions that might preclude you from donating your own blood, such as some heart disorders.

 It is advisable to take minerals and vitamins to help your body replace the blood lost by your donations.  Take these from the day of your first donation until the day prior to surgery:

                                1.  Iron, 1 -3tablet three times a day.

                                2.  Folic acid, 1 mg once a day. (Fefol is a good combination tablet)

                                3.  Vitamin C, 250 mg twice a day.

Blood bank blood is blood donated by a member of the general public.  Potential donors fill out an extensive health questionnaire and the blood is rigorously tested.  There are only very minor risks associated with receiving volunteer blood.

DISEASE TRANSMISSION THROUGH BLOOD TRANSFUSION

Nowadays all blood is screened for AIDS. Other diseases can also be transmitted through blood, for example hepatitis.  The chances of getting AIDS through volunteer blood are thought to be about 1:250,000 or less.

WHERE TO DONATE YOUR BLOOD

You may donate blood at the recognized pathology collection sites.

Jehovah’s Witnesses: Although most patients require two or more units of blood transfusion after knee replacement, such transfusion is not mandatory.  Surgeons have operated upon many Jehovah’s Witness patients and have been able to avoid transfusion altogether.  The main disadvantage is that it takes longer for you to get back to full strength.  It may take three months or more on iron and vitamin supplements to return the blood level to normal.

Copyright © 2005 [Southern Orthopaedics]