Post-operative red cell salvage in total knee replacement

Post-operative cell salvage (PCS) reduces homologous blood use after knee replacement but liberal indication for transfusion in previous studies resulted in high homologous transfusion requirements. We evaluated PCS in patients undergoing knee replacement using a restrictive transfusion trigger (Hb <8.5g/dl). Forty patients underwent knee replacement with either PCS (n=20) or with standard wound drains (n=20). Blood losses and transfusion requirements were recorded prospectively. Mean (SD) post-operative blood loss with PCS was 656 (317)ml, of which 433 (197)ml were re-infused. Control blood loss was comparable at 591 (328)ml. Blood transfusion was given to only one PCS patient; 2U, and five controls who received a total of 12U of homologous blood.