Abstract

Introduction

Arthroplasties of hip and knee are associated with blood loss, which may lead to adverse patient outcome. Performing arthroplasties in Jehovah’s Witness patients who do not accept transfusion has been a matter of concern. We developed a protocol, which avoids transfusion in arthroplasties of Jehovah’s Witness patients, and evaluated the feasibility and safety of the protocol.

Materials and methods

The target of preoperative hemoglobin was more than 10 g/dL. When preoperative hemoglobin was lower than 10 g/dL, 4000 U erythropoietin (3 times a week) and 100 mg iron supplement (every day) were administered until the hemoglobin reached 10 g/dL. When the preoperative hemoglobin was higher than 10 g/dL, 4000 U erythropoietin and 100 mg iron supplement were administered once, before operation. During the operation, cell saver was used. Postoperatively, erythropoietin and iron supplements were administered until the hemoglobin reached 10 g/dL, similar to the preoperative protocol. We evaluated the feasibility of our protocol, perioperative complications and hematologic changes.

Results

From 2002 to 2014, 186 Witness patients visited our department. In 179 patients (96.2 %), 77 total knee arthroplasties, 69 bipolar hemiarthroplasties and 33 total hip arthroplasties were performed. The mean hemoglobin level was 12.3 g/dL preoperatively, 9.4 g/dL on postoperative day 3 and 10.3 g/dL on postoperative day 7. One patient died immediately after the arthroplasty and the remaining 178 patients survived.

Conclusions

Total joint arthroplasty could be done without transfusion using this protocol in most of our patients. The rates of infection and mortality were similar with known infection and mortality rates of arthroplasties. In patients who do not want allogeneic transfusions, our protocol is a safe alternative to perform joint arthroplasties.

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GENERAL

COLUMNA VERTEBRAL

HOMBRO Y CODO

MANO Y MUÑECA

CADERA Y PELVIS

RODILLA

PIE Y
TOBILLO

ORTOPEDIA PEDIÁTRICA

TRAUMATOLOGÍA DEPORTIVA

ARTÍCULOS MÉDICOS

Cadera y pelvis, Rodilla

A protocol avoiding allogeneic transfusion in joint arthroplasties

A protocol avoiding allogeneic transfusion in joint arthroplasties

Abstract

Introduction

Materials and methods

Results

Conclusions

Keywords

Artículos por Especialidades

NOSOTROS

DOCENCIA

BIBLIOTECA

OTROS

SECRETARÍA TÉCNICA

Especialidades

GENERAL

COLUMNA VERTEBRAL

HOMBRO Y CODO

MANO Y MUÑECA

CADERA Y PELVIS

RODILLA

PIE Y TOBILLO

ORTOPEDIA PEDIÁTRICA

TRAUMATOLOGÍA DEPORTIVA

ARTÍCULOS MÉDICOS

Cadera y pelvis, Rodilla

A protocol avoiding allogeneic transfusion in joint arthroplasties

A protocol avoiding allogeneic transfusion in joint arthroplasties

Abstract

Introduction

Materials and methods

Results

Conclusions

Keywords

Artículos por Especialidades

NOSOTROS

DOCENCIA

BIBLIOTECA

OTROS

SECRETARÍA TÉCNICA

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