Findings and Conclusion To our knowledge , this is the first meta- analysis to compare the clinical results between PAT and a control in joint replacement patients .
This meta- analysis has proven that the use of a PAT reinfusion system reduced significantly the dem and for ABT , the number of patients who require ABT and the cost of hospitalization after total knee and hip arthroplasty .
This study , together with other previously published data , suggests that PAT drains are beneficial .
Background Total hip or knee arthroplasty is an elective procedure that is usually accompanied by substantial blood loss , which may lead to acute anemia .
As a result , almost half of total joint arthroplasty patients receive allogeneic blood transfusions ( ABT ) .
Many studies have shown that post-operative auto-transfusion ( PAT ) significantly reduces the need for  ABT  , but other studies have question ed the efficacy of this method .
Perioperative intravenous iron, with or without erythropoietin, plus restrictive transfusion protocol reduce the need for allogeneic blood after knee replacement surgery.
BACKGROUND Unilateral total knee replacement ( TKR ) results in a substantial blood loss and 30 to 50 percent of patients receive allogeneic blood transfusion ( ABT ) . Therefore , the effectiveness of a restrictive transfusion trigger ( hemoglobin [ Hb ] level < 8 g/dL ) plus stimulation of erythropoiesis was evaluated , with or without blood salvage , for reducing ABT in TKR patients . STUDY DESIGN AND METHODS A series of 139 consecutive of primary TKR patients received perioperative iron sucrose ( 2 x 200 mg/48 hr , intravenously [ IV ] ) , plus preoperative erythropoietin ( EPO ; 1 x 40.000 UI , sc ) if preoperative Hb level was less than 130 g per L ( Group A ) . This protocol was applied to another series of 173 consecutive TKR patients who also received postoperative unwashed shed blood ( USB ) if preoperative Hb level was less than 130 g per L ( Group B ) . Perioperative clinical and laboratory data were gathered . RESULTS No adverse effects of iron sucrose , EPO , or USB administration were witnessed , and only 13 patients received ABT overall ( 4 % ) . No major differences in perioperative blood counts or iron metabolism variables were observed between groups , but stimulation of erythropoiesis seemed to be more pronounced in those patients receiving EPO ( p < 0.05 ) . There were no differences in postoperative complications between groups , but length of hospital stay for patients with a preoperative Hb level of less than 130 g per L was shorter in Group B ( p < 0.05 ) . CONCLUSION This blood saving protocol seems to be effective for reducing ABT in TKR patients . Which patients are more likely to benefit from either perioperative iron administration or selective addition of postoperative blood salvage to pharmacologic treatment , however , needs to be further evaluated
Findings and Conclusion To our knowledge , this is the first meta- analysis to compare the clinical results between PAT and a control in joint replacement patients .
This meta- analysis has proven that the use of a PAT reinfusion system reduced significantly the dem and for ABT , the number of patients who require ABT and the cost of hospitalization after total knee and hip arthroplasty .
This study , together with other previously published data , suggests that PAT drains are beneficial .
Background Total hip or knee arthroplasty is an elective procedure that is usually accompanied by substantial blood loss , which may lead to acute anemia .
As a result , almost half of total joint arthroplasty patients receive allogeneic blood transfusions ( ABT ) .
Many studies have shown that post-operative auto-transfusion ( PAT ) significantly reduces the need for  ABT  , but other studies have question ed the efficacy of this method .