Influence of acid-citrate-dextrose anticoagulant on blood quality in retransfusion systems after total knee arthroplasty.

Handel M, Winkler J, Hornlein RF, Northoff H, Heeg P, Sell S
Arch Orthop Trauma Surg 2002;122(5):269-273.
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The authors propose to refrain from ACD anticoagulation in orthopedic postoperative autotransfusion. Their conclusion is not convincing. Products of activation of coagulation and fibrinolysis were not tested, although the main reason for anticoagulation is to decrease those dangerous contaminants. How can the authors justify to a patient with relevant blood loss the failure of the system because of clotting?

– E. Hansen

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