Allogeneic blood transfusion reduction by risk-based protocol in total joint arthroplasty.

The authors demonstrate a significant reduction in allogeneic blood transfusions (ABT) by utilizing erythropoietin, preoperative autologous blood donation or iron support according to an algorithm that, preoperatively, identifies 4 different levels of ABT risk and consequently 4 different treatment options. The use of retrospective controls limits the strengths of the study conclusions but the relevance of a comprehensive perioperative blood management strategy based on body weight and hematocrit seems to be confirmed.

– Giovanni Inghilleri