Skip to main content

Table 2 Different methods of blood conservation and their complications.

From: Use of Tranexamic acid is a cost effective method in preventing blood loss during and after total knee replacement

Alternatives used to avoid allogenic blood transfusions and their disadvantages
Preoperative Blood Donation (PAD) • Cardiac, Vasovagal (Risk Factors: Younger Age, Lower weight, 1Sttime donation) [34]
• 12 times increase in Anginal and Vasovagal complications (Risk Factor: 1sttime donation) [35]
• Overall increase frequency of transfusion (Risk Factor: Lower Preoperative Hematocrit) [36, 37]
• Not Cost Effective in Orthopaedic Procedures [38](More expensive to produce one unit of autologous blood, Cost also incurred in disposal of more than half of the blood discarded which is not used)
Acute Normovolemic Hemodilution (ANH) Not effective in Orthopedic Procedures (data termed inconclusive) [39]
Perioperative red cell salvage (PCS) Cost effectiveness of the postoperative blood collection devices was challenged (1stsix hour collection would cost 31-35 million dollars) [40]
Deliberate Hypotension DH) Persistent hypotension, Reactionary haemorrhage, Cardiac Ischemic Injury, Ischemic Optic neuritis [4143]
Recombinant Human Erythropoietin (RHE) Routine use not justified due to high cost [44]
Tranexamic acid Very effective [9, 20]
Aprotinin • Low dose not effective in orthopedic procedure [45]
• Evidence has been published to suggest an increase in renal events in patients given aprotinin when compared to those where tranexamic acid was used [46]