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Blood transfusion rates drop in major joint replacement surgery

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Blood transfusion rates drop in major joint replacement surgery

Blood transfusion rates in elective hip and knee replacement patients have been drastically reduced at Western Health due to the introduction of a patient blood management program which includes identifying and treating anaemia in patients before their surgery. ​

Total hip and total knee replacement surgery can involve considerable blood loss and often results in  patients requiring a transfusion of compatible donor blood.  While Australia has one of the safest blood supplies in the world, blood transfusion is not without risk.

Western Health’s Department of Anaesthesia and Pain Medicine and the Orthopaedic Unit have introduced a first of its kind Tranexamic acid (TXA) protocol for patients having elective hip and knee replacement surgery. TXA has been shown to reduce blood loss during total hip and knee replacement, decreasing the need for blood transfusion.

The new program includes screening patients for anaemia prior to their surgery and those with anaemia are investigated, referred and given treatment such as an iron infusion prior to surgery, reducing the likelihood they will require a blood transfusion. 

Preoperative anaemia increases the likelihood that a patient will require a blood transfusion and is associated with an increased risk of adverse outcomes, such as increased postoperative infections and a longer hospital stay.

Susan McGregor, Western Health Transfusion Clinical Nurse Consultant, said transfusion rates have dropped by 28 per cent in total hip replacement patients and about 10 per cent in knee replacement surgery, since the program was introduced in 2012.

“This is a fantastic result which reflects the commitment and hard work of our teams in constantly improving patient outcomes and using our precious blood supplies wisely.

“The preoperative anaemia screening program is expected to be adopted in a number of other Western Health elective surgery areas such as gynaecology.

“We have also had a lot of interest from other health services, particularly in the TXA protocol.”

Findings will be presented at this year’s Australian Orthopaedic Association Annual Scientific Meeting.