This retrospective study shows again that intra- and postoperative blood salvage can minimize allogeneic transfusions. For the recent discussion about the use of unwashed drainage blood the paper is remarkable in demonstrating that cell washing is feasible. The cost analysis is (as usual) limited to a specific situation, as the cell sever costs are high (386 US$), the predonation costs could be reduced by proper patient selection, and the patients seemed to be overtransfused anyway (postoperative Hct 33/34, weakness during physical therapy is not an accepted indication for transfusion). So the conclusion should be the feasibility and effectiveness of perioperative blood salvage in hip and knee surgery, and not the discontinuation of predonations.

– E. Hansen.

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