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 .
Retransfusion of filtered shed blood in primary total hip and knee arthroplasty: a prospective randomized clinical trial.
BACKGROUND Allogeneic blood transfusions are associated with a number of well-recognized risks and complications . Postoperative retransfusion of filtered shed blood is an alternative to ( reduce ) allogeneic blood transfusion . The objectives of this study were to evaluate the clinical efficacy of retransfusion of filtered shed blood and to evaluate the complications , in particular febrile reactions . STUDY DESIGN AND METHODS In this clinical trial 160 patients undergoing primary total hip or knee replacement were r and omly assigned to receive either a retransfusion system ( Bellovac , AstraTech AB ) or a regular drain ( Abdovac , AstraTech AB ) . Patients with a preoperative hemoglobin ( Hb ) level of between 13.0 and 14.6 g per dL were included . The shed blood was returned 6 hours after operation . After surgery the anesthesiologist determined the transfusion trigger . When Hb level dropped below this trigger , an  allogeneic blood transfusion  was given . The following data were obtained : number of allogeneic blood transfusions , total volume of blood collected in the bag used for retransfusion , perioperative Hb levels , febrile reaction , and other complications . RESULTS In the control group 19 percent of the patients received at least one allogeneic blood transfusion . In the study group this percentage was 6 percent of the patients ( p = 0.015 ) . Comparing total knee and total hip arthroplasty ( control vs. study ) the percentages were , respectively , 16 percent versus 2 percent ( p = 0.040 ) and 21 percent versus 11 percent ( NS ) . On average 308 mL of filtered shed blood was retransfused in the study group . In the study group 18 percent of patients had febrile reactions compared to 20 percent in the control group . CONCLUSION Postoperative retransfusion of filtered shed blood is effective for decreasing allogeneic blood transfusions after total hip and knee arthroplasty . There was no relationship between retransfusions and postoperative febrile reactions
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 .