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. 2023 Sep 8;2023(9):CD001888. doi: 10.1002/14651858.CD001888.pub5

11. Overview of included studies (PICO) ‐ Orthopaedic (mixed).

Study details Population (surgery type) CS detail Intervention detail Control detail Outcomes reported (time point)
Atay 2010
RCT 
Registration: N/A 
Country: Turkey 
N = 77 Orthopaedic (hip or knee) ‐ arthroplasty Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: Hb < 8 g/dL or Hct < 25% 
System: Transolog, Heim Medizintechnik, Germany Study group
N = 37 Control group
N = 40

  • Transfusions (NR)

  • Volume (NR)
Gannon 1991
RCT 
Registration: N/A 
Country: USA 
N = 239 Orthopaedic (hip or knee) ‐ arthroplasty Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: Hb < 9 g/dL 
System: Solcotrans (Solco Basle, Inc, Rockland, MA.) Study
N = 124 Control
N = 115

  • Transfusions (post‐op 48 hours)

  • Volume (NA)

  • Infection (NR)
Healy 1994
RCT 
Registration: N/A 
Country: USA 
N = 128 Orthopaedic (hip/knee ‐ arthroplasty; spine ‐ fusion) Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: No protocol 
System: Solcotrans (Smith and Nephew, Mephis, Tennessee) or Orthevac (Deknatel, Fall River, Massachusetts) Group 1: Orth‐Evac; and group 2: Solcotrans
N = 84 Group 3: banked blood (autologous or homologous); Hemovac standard wound drain
N = 44

  • Transfusions (in‐hospital)

  • Volume (NA)

  • VTE/thrombosis (NR)

  • DVT (NR)

  • PE (NR)
Koopman‐van Gemert 1993b
RCT 
Registration: N/A 
Country: The Netherlands 
N = 60 Orthopaedic (hip ‐ arthroplasty; spine ‐ fusion) Timing of collection: both intra‐ and postoperatively
Washing: washed 
Transfusion threshold: Hct < 30% 
System: Haemonetics Haemolite‐2 (Haemonetics Corporation, Braintree, USA Group 1: perioperative autotransfusion
N = 30 Group 2: homologous transfusion only
N = 30

  • Transfusions (intraoperative and post‐op)

  • Volume (intraoperative and post‐op)

  • Blood loss (perioperative)
Kristensen 1992
RCT 
Registration: N/A 
Country: Denmark 
N = 56 Orthopaedic (hip/knee) ‐ arthroplasty Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: Hb < 8.5 g/dL 
System: Solcotrans Orthopaedic (Solco Basle (UK) Ltd.) Autologous hip, autologous knee
N = 31 Homologous hip, homologous knee
N = 25

  • Volume (NA)

  • Blood loss (NA)
Mac 1993
RCT 
Registration: N/A 
Country: USA 
N = 91 Orthopaedic (hip or knee) ‐ arthroplasty Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: No threshold 
System: Stryker Constavac Group 1: Constavac (cell salvage group)
N = 41 Group 2 = Haemovac (suction and discard blood)
N = 50

  • Blood loss (NA)

  • PJI (1 year)

  • Hospital LOS
Mah 1995
RCT 
Registration: N/A 
Country: Australia 
N = 205 Orthopaedic (hip or knee) ‐ arthroplasty Timing of collection: both intra‐ and postoperatively
Washing: NR 
Transfusion threshold: Hb < 100 g/L 
System: Electromedics BT‐795, Engelwood, USA Autologous blood salvage (ABS)
N = 91 no‐ABS
N = 114 None reported
Mauerhan 1993
RCT 
Registration: N/A 
Country: USA 
N = 111 Orthopaedic (hip/knee) ‐ arthroplasty Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: No threshold 
System: CBC ConstaVac, Stryker Surgical, Kalamazoo, MI Study group
N = 57 Control group
N = 54

  • Transfusions (perioperative)

  • Blood loss (NA)
Moonen 2007
RCT 
Registration: N/A 
Country: The Netherlands 
N = 160 Orthopaedic (hip/knee) ‐ arthroplasty Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: Hb < 9.7 g/dL 
System: Bellovac, AstraTech AB, Molndal, Sweden) Reinfusion/Study group
N = 80 Control group (regular drain (Abdovac, AstraTech AB))
N = 80

  • Transfusions (in‐hospital)

  • Volume (NA)

  • PJI (NR)

  • Wound complication (NR)

  • VTE/thrombosis (NR)

  • DVT (NR)

  • PE (NR)
So‐Osman 2006
RCT 
Registration: N/A 
Country: The Netherlands 
N = 69 Orthopaedic (hip/knee) ‐ arthroplasty Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: GUIDELINE: CBO Consensus Guideline, 2004 
System: DONOR system, Van Straten Medical, Nieuwegein, the Netherlands or Bellovac A.B.T., Astra Tech,
Zoetermeer, the Netherlands Group B (reinfusion system of continuous suction) & Group C (reinfusion system of intermittent suction)
N = 47 Group A (standard closed suction wound drainage system)
N = 22

  • Transfusions (NR)

  • Volume (NR)

  • Blood loss (NA)

  • Mortality (NR)

  • Hospital LOS
So‐Osman 2014
RCT 
Registration: Retrospective (one year) 
Country: The Netherlands 
N = 2442 Orthopaedic (hip/knee) ‐ arthroplasty Timing of collection: both intra‐ and postoperatively 
Washing: both 
Transfusion threshold: GUIDELINE: Dutch national transfusion protocol 
System: OrthoPat Cell Saver; Bellovac‐abt reinfusion drain; DONOR reinfusion drain Part 1: Group 1 (AUTO and EPO) and group 3 (AUTO); and part 2 "AUTO"
N = 1481 Part 1: Group 2 (EPO, no CS) and Group 4 (no EPO, no CS); and part 2 "Control/No AUTO"
N = 961

  • Transfusions (3 months)

  • Volume (3 months)

  • Blood loss (NA)

  • DVT (3 months)

  • PE (3 months)

  • MI (3 months)
Springer 2016
RCT 
Registration: Retrospective (2 months) 
Country: USA 
N = 121 Orthopaedic (hip or knee) ‐ arthroplasty Timing of collection: both intra‐ and postoperatively 
Washing: washed 
Transfusion threshold: No threshold 
System: OrthoPAT, Haemonetics, Braintree, MA Reinfusion drain
N = 60 Hemovac drain
N = 61

  • Transfusions (until discharge)
Thomassen 2014
RCT 
Registration: Retrospective (1 month) 
Country: The Netherlands 
N = 575 Orthopaedic (hip/knee) ‐ arthroplasty Timing of collection: postoperative 
Washing: unwashed 
Transfusion threshold: GUIDELINE: Dutch national transfusion protocol 
System: Bellovac ABT System WellSpect Healthcare, Molndal, Sweden Groups B (6 hrs) and Group C (24 hrs)
N = 385 Group A (No wound drainage)
N = 190

  • Transfusions (in‐hospital)

  • PJI (6 weeks)

  • DVT (6 weeks)

  • PE (6 weeks)

  • MI (6 weeks)

  • Hospital LOS (NA)
Zhang 2008
RCT 
Registration: N/A 
Country: China 
N = 40 Orthopaedic (any) Timing of collection: intraoperative 
Washing: washed 
Transfusion threshold: No protocol 
System: Haemonetics Company, USA Group 2: simple autologous blood intraoperative
N = 20 Group 3: untreated, no blood protective measures
N = 20

  • Transfusions (48 hours)

  • Volume (NR)

  • Blood loss (intraoperative)

ANH: acute normovolemic haemodilution; AT: autotransfusion; CABG: cardiopulmonary bypass graft; CS: cell salvage; CVA: cerebrovascular accident; DVT: deep vein thrombosis; Hb: haemoglobin; Hct: haematocrit; LOS: hospital length of stay; MACE: major adverse cardiovascular events; MI: myocardial infarction; N: planned recruitment (as reported by the study); NA: not analysable; NR: not reported; PE: pulmonary embolism; PJI: prosthetic joint infection; RAP: retrograde autologous prime; RCT: randomised controlled trial; VTE: venous thromboembolism

"Registration: N/A" means 'not applicable' as the study was published before 2010
"Volume" refers to mean transfusion volume
"Transfusions" refers to number of people receiving an allogeneic transfusion