Local wound and systemic coagulation/fibrinolysis responses in hip arthroplasty: Influence of allogeneic and autologous blood transfusion

Abstract

22 patients undergoing elective hip arthroplasty were studied. in 12 patients, a closed-loop au-totransfusion system, without anticoagulant, was used and 10 had an ordinary wound drainage allowing repeated blood sampling from the wound. Plasma concentrations of antithrombin (AT), fibrin, soluble (SF) and fibrin D-dimer were determined preop-eratively, 3,8, and 24 hours after start ing surgery.

Wound drainage blood had increased concentrations of SF and fibrin D-dimer and decreased concentrations of AT compared to reference values and systemic concentrations in patients. Plasma concentrations of SF, fibrin D-dimer and AT did not differ between patients receiving retrieved blood and those receiving stored red blood cell concentrates (RBCs). Patients receiving blood transfusions had lower AT concentrations at 8 hours after starting surgery than those not receiving such a transfusion.