Perioperative blood salvage as an alternative to predonating blood for primary total knee and hip arthroplasty.

A total of 200 consecutive patients who underwent primary total knee or hip arthroplasty were reviewed to assess the efficacy of perioperative blood salvage and retransfusion. Five of 132 (3.8%) patients undergoing total knee arthroplasty and 3 of 68 (4.4%) patients undergoing total hip arthroplasty required allogeneic transfusion in addition to retransfusion of salvaged autologous blood. The risk of receiving allogeneic transfusion in addition to retransfusion of salvaged blood was 1.2% (2 of 173) in patients with a preoperative hematocrit of > or=37%. The risk of requiring allogeneic transfusion was 22% (6 of 27) in patients with a preoperative hematocrit of <or=37% (P<or=.01). Perioperative blood salvage is safe and cost-effective and makes it possible to discontinue the practice of predonating blood for primary total knee arthroplasty and total hip arthroplasty in patients with a preoperative hematocrit >37%.