Risks associated with blood transfusion after total knee arthroplasty

J Arthroplasty. 2004 Apr;19(3):281-7. doi: 10.1016/j.arth.2003.10.013.


A retrospective study of 1,402 patients who underwent primary total knee arthroplasty (TKA) (1,194 unilateral, 208 bilateral) was performed. The strongest predictors for allogenic transfusion after surgery were advancing age (P<.001), low preoperative hemoglobin (P<.001), and the use of low-molecular-weight heparin postoperatively (P<.01). Pre-donation of 1 unit of autologous blood before TKA decreased the allogenic transfusion rate from a baseline of 38% to 11%, whereas pre-donating 2 units lowered the rate of breakthrough transfusion of allogenic blood to 7%. A patient with a preoperative hemoglobin >150 g/L or who is younger than age 65 with a preoperative hemoglobin >130 g/L may not benefit from pre-donation, and a high rate of wastage may result.

MeSH terms

  • Age Factors
  • Aged
  • Arthroplasty, Replacement, Knee*
  • Blood Loss, Surgical
  • Blood Transfusion / statistics & numerical data
  • Blood Transfusion, Autologous / statistics & numerical data*
  • Female
  • Hemoglobins / analysis
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Logistic Models
  • Male
  • Osteoarthritis, Knee / surgery
  • Postoperative Care
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Transfusion Reaction*


  • Hemoglobins
  • Heparin, Low-Molecular-Weight