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 red blood cell transfusion and outcome in stable patients after elective major vascular surgery.
OBJECTIVES Definitive evidence that red blood cell transfusion improves outcome after vascular surgery is lacking . The aims of the study were to determine , among stable consecutive patients who underwent elective major vascular surgery  , ( 1 ) the association between postoperative transfusion and 30-day death , myocardial infa rct ion , and both , and ( 2 ) and if this association differs according to the presence of postoperative anaemia ( haemoglobin value less than 9.0 g/dL within 7 days after surgery ) . METHODS A retrospective observational study was conducted on 359 patients prospect ively screened according to the ACC/AHA guidelines for preoperative risk in non-cardiac surgery . Main outcome was 30-day death ; secondary outcomes 30-day myocardial infa rct ion , and composite of 30-day myocardial infa rct ion or death . RESULTS Of the patients included , 95 ( 26.5 % ) received at least one unit of red blood cells . Patients who received transfusion had a significantly increased hazard of 30-day death ( hazard ratio [ HR ] 11.72 , 95 % confidence interval [ CI ] 3.92 - 35.10 ; p<0.0001 ) , myocardial infa rct ion ( HR 3.3 , 95 % CI 1.7 - 6.1 ; p=0.0003 ) , and both ( HR 4.0 95 % CI 2.2 - 7.3 ; p<0.0001 ) . Such associations held even after adjusting for baseline characteristics , surgical risk , bleeding , and propensity to receive transfusion . There was a significant interaction between transfusion and postoperative anaemia ( p=0.012 ) . In patients without anaemia , transfusion was associated with higher risk of 30-day death ( HR 19.20 , 95 % CI 3.99 - 92.45 ; p=0.007 ) , myocardial infa rct ion ( HR 5.05 , 95 % CI 2.23 - 11.44 ; p=0.0001 ) , and both . Conversely , in patients with anaemia this association was not significant . CONCLUSIONS In patients who underwent elective major vascular surgery , perioperative transfusion was associated with a significantly increased risk of 30-day events which was more attributable to patients with lesser degree of anaemia . Our data caution against the use of liberal transfusion in stable vascular surgery patients
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 .