May
2010

Tranexamic acid reduces allogenic transfusion in revision hip arthroplasty.

Noordin S, Waters TS, Garbuz DS, Duncan CP, Masri BA
Clin Orthop Relat Res 2010; Jun 24 [Epub ahead of print].
NATA Rating :
Review by : E. Bisbe
NATA Review

In this study, the authors retrospectively reviewed revision hip arthroplasties to assess the effectiveness of a Blood Utilization Program, including the use of tranexamic acid, and to determine the variables associated with a higher risk of transfusion.

They included 101 patients referred to the Blood Utilization Program, compared with 58 patients that were not because they required urgent surgery. The results show major differences between groups, such as a higher infection rate and less operative time in the control group, which probably influences the results. Although the authors recognize the limitations of this study, they conclude that there was no difference in transfusion rate in patients referred to the Blood Utilization Program; however, they found a significant reduction in the number of units transfused. The intraoperative use of tranexamic acid was associated with reduced transfusions regardless of the dosage used.

The authors suggest that guidelines for patients undergoing revision hip arthroplasty need to be revised accordingly. In my opinion, well-sesigned designed studies are required to evaluate the efficacy of a Blood Utilization Program.

– Elvira Bisbe